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PRACTICE OF 

OSTEOPATHY 

ITS PRACTICAL APPLICATION 
TO THE VARIOUS DISEASES 
OF THE HUMAN BODY 

Fifth Edition Revised and Enlarged 



ILLUSTRATED 
WITH OVER 

100 HALFTONE 
ENGRAVINGS 



^X BY 

CHAS. H. MURRAY, A. B., D. O. 

AUTHOR OF OSTEOPATHIC GYNECOLOGY, GENUINE OSTB- 
OPATHY, THE OSTEOPATHIC TRUTH, PRACTICAL 
HEALTH HINTS, THE PRACTICE OF SOMAP- 
ATHY, AND THE SUCCESSFUL PROMO- 
TION OF GENUINE OSTEOPATHY 



ELGIN, ILLINOIS 
1918 



1^2 54 



COPTRIGHT, 1909 
BY CHAS. H. MURRAY 

COPYRIGHT, 1912 
BY CHAS. H. MURRAY 

COPYRIGHT, 1918 
BY CHAS. H. MURRAY 



©CI.A481625 



FEB -5 ibiy 

/Wo - \ 



Preface to the Fifth Edition 

We trust that, wherever EngUsh is read, this edi- 
tion will meet the hearty approval of doctors, as 
did former editions. 

Special attention is called to the new treatment 
for Partial Deafness and Deafness and Hay Fever. 

Chas. H. Murray. 

Elgin, 111. 



Preface to the Third Edition 

When after the brief space of two and one-half 
years I had the pleasure of being informed by the 
publisher that a third edition of my Textbook of 
Practice of Osteopathy was called for, I resolved to 
make it in every respect as perfect as was in my power. 
The entire work has been carefully and thoroughly 
revised, considerable new material has been added, 
bringing the work up to date and fully in the forefront 
of all recent but proven investigations. Many new 
illustrations have been added. 

By these improvements I have tried to make the 
book worthy of the kind reception accorded it by the 
Medical and Osteopathic profession and the medical 
press. The second edition was largely taken by Osteo- 
paths. The writer has been pleased with the way 
medical doctors have been successful in obtaining 
splendid results from the treatments herein described. 

Chas. H. Murray. 

Elgin, 111. 



Preface to the First Edition 

Osteopathy was born in the fertile mind of Doc- 
tor Andrew Taylor Still in 1875. Like other good 
gifts from God it bears) evidence of being sent by 
Divine providence. Drugs having proven of no 
value in serious cases in the doctor's own house- 
hold he was led to look for something better. Oste- 
opathy had its necessary growth and development 
amidst surroundings that tested its right to exist- 
ence at every step. The science withstood the fire of 
merciless criticism, but the scientific truth, that 
God made the human machine perfect, and as long 
as it is kept in order it will perform its proper func- 
tions and keep in good health to a ripe old age, 
came out more than conqueror. 

No one but Doctor Still and his devoted family 
will ever know the hard and bitter struggle, when 
deserted by many relatives and friends he bore 
the brunt of the battle which was waged after he 
stepped out of the medical profession and declared 
for Osteopathy. 

So successful was he in curing those whose dis- 
eases had resisted all other forms of treatment that 
he was compelled to teach the science that others 
might treat suffering humanity. 

There have been a number of other schools start- 
ed, both East and West, which have also been send- 

5 



ing out graduates until thousands of practitioners) 
are now practicing the science in the United States, 
and there are representatives in nearly all parts 
of the world. So the work has grown and pros- 
pered and is rapidly making its impress felt for 
good among all schools of healing. 

While the above is true, those In the field can 
not do a tithe of the work that is necessary. Many 
in the smaller towns and in the country must go 
without the treatment, while very many are at- 
tempting to practice who know comparatively little 
of the science. 

The object of this work is to meet this very 
urgent need on the part of practitioners of all 
schools, and to present the practical side of Oste- 
opathy in a very plain and simple manner. 

To the many practitioners of the science who 
have not taken the regular work in colleges, yet 
who will continue to practice, it will prove of the 
greatest value. Whil-e the work does not deal with 
the theory of Osteopathy to any great extent, the 
practical side of the science is presented and empha- 
sized in such a manner as to be of great assistance 
to medical doctors who have not time nor the in- 
clination to take a regular course in Osteopathy, 
and who will here receive a knowledge of the 
science that will be of value to them and to their 
patients. 

Thousands in every walk of life will be helped by 
the general treatment as indicated in this work. 
They will live longer and feel more like living while 

6 



they live if the various ligaments of the spine and 
joints are not allowed to become hard and stiff and 
short, thus creating a tension and stiffness in parts 
that should be soft and pliable to permit a good 
nerve supply and circulation. 

The author believes that all that is good in 
medicine should become common property; that 
there is too much ignorance among the people con- 
cerning the healing art. He fully believes that 
Osteopathy is the very best in medicine, and in 
helping to make its use more universal he is help- 
ing humanity. 

Chas. H. Murray. 

Elgin, Illinois. 



PRACTICE OF 
OSTEOPATHY 



OSTEOPATHIC TECHNIQUE 

The most important part of osteopathic pro- 
cedure is the examination of the patient, the de- 
termination of the lesion, the discovery of what is 
wrong in the human building. In some cases nature 
has taken care of a former abnormality of struc- 
ture, and then what was once abnormal has become 
normal. An attempt to make a forcible correction 
of the apparant abnormality would lead to trouble. 
In some cases most serious results would ensue. 

In other cases, where the real lesion is not dis- 
covered, months of routine treatment would be 
worse than useless and might be a detriment rather 
than a help to the patient. So we say the first th'ing 
and the most important thing to do is to make a 
careful and painstaking examination of the patient. 

If there are no marked osteopathic lesions, the 
disease in question having been brought on by 
overwork or abuse of function, as overeating or 
drinking, there are certain definite areas in which 
the Osteopath works, and by securing a better 
nerve and blood supply hastens the recovery of the 
patient. This is especially true in cases of sickness 
induced by the various specific microorganisms 
which are the exciting agents of a long list of 



10 Practice of Osteopathy 

acute diseases, as pneumonia, la grippe, typhoid 
fever, scarlet fever, measles, chicken pox, mumps, 
v^hooping cough, diphtheria, erysipelas, tubercu- 
losis, etc., etc. Even in many of these diseases 
there are predisposing lesions that weaken certain 
areas of the body and permit the entrance and 
growth of these exciting organisms. 

Yet in these very regions in which the Osteopath 
works to help recoveries there are, in a majority of 
cases, lesions of muscle, ligament, and of the bony 
structure as well, which have been induced reflexly. 
The abused organs or the diseased organs have 
sent nerve impulses to the cord, and they have sent 
them in such large numbers that they have in turn 
been sent out to the muscles and other structures 
lying in close proximity. A muscle is tense in pro- 
portion to the number of nerve impulses communi- 
cated to it. These abnormal nerve impulses, long 
continued, have produced contractures; these in 
turn, by pulling on the bones to which they are 
attached, have produced bony lesions. Some of 
these bring pressure to bear on the spinal cord 
and other structures, and in this manner aggravate 
the disease. 

For the beginner in Osteopathy it will be better 
to have the back of the patient bare. If the patient 
is a lady, a gown or kimono may be worn which 
opens in the back. A suitable kimono for taking 
the treatment is illustrated in Fig 2. After the 
operator has had some experience he will readily 
examine the spine of patients through the gar- 



Osteopathic Technique 11 

ments, the under clothing at least. As a general 
thing we know very little about our own 
bodies. Many are more conversant with the normal 
cow, horse or hog than with the normal human 
body. It will be an excellent thing for the one who 
expects to make a vocation or even an avocation 
of Osteopathy to study carefully the normal body. 
Study a number of them. Become thoroughly ac- 
quainted with the normal body, and especially with 
the normal spine. In this way you will be all the 
more readily able to detect the abnormal. 

The practitioner should study the various de- 
grees of motility of the spines, joints, necks, backs, 
etc., of normal individuals. He should learn the 
various degrees of tension, tenderness, and pliability 
of the various muscles of persons in health. A knowl- 
edge of anatomy and physiology will be very helpful. 

Lesions. It is not every vertebra that is out 
of line laterally, or deviates anteriorly or posterior- 
ly, that may be said to be out of position in such 
a manner as to constitute a lesion. Before we can 
say that a deviation of such a character constitutes 
a lesion it ought to produce some pathological con- 
dition, or ill feeling of some kind. There should 
be some change in color and some temperature near 
the abnormality. There should be some contraction 
in the muscles and ligaments. There should be 
some inflammation, or a congestion bordering on in- 
flammation, near the seat of lesion. There will be 
pain in nearly all recent lesions. Pain will be 
present on pressure. In some conditions the 



12 Practice of Osteopathy 

muscles in close proximity will be slightly swollen 
and have a rigid feeling when worked over with 
the hand. It will be always safe and beneficial to 
manipulate the spine, ribs, ligaments, muscles, and 
other tissues, but do not attempt to correct a mis- 
placed bone until it is known to be out of place in 
such a manner as to cause pressure, or is forming 
an obstruction that is causing some illness. Never 
manipulate a tubercular joint or spine. Do not 
cause pressure on lymphatic glands. 

Since the publication of the second edition of this 
book, doctors who are doing research work in Osteop- 
athy are of the opinion that pressure on nerves re- 
sulting from vertebral displacements is not a cause of 
disease. This view is in harmony with the author's 
experience, with one exception, and that is in those 
cases where a vertebra or vetebrae are misplaced an- 
teriorly. This allows pressure to be exerted upon the 
spinal nerves as shown in Fig. A. In backward dis- 
placements the spinal foramen is made larger, and 
there can be no pressure exerted on spinal nerves. 
This is especially true in those cases where Pott's 
disease exists and there is a backward displacement of 
the vetebrae amounting to deformity. See Fig. B. 

Disease and disturbances of the circulation are not, 
as is generally believed by Osteopaths, caused by arte- 
rial or venous obstructions occasioned by misplaced 
vertebrse. Vertebral displacements and an obstructed 
circulation have been the two great points which 
Osteopaths have kept before the public. They have 
believed this, and acting on this belief, in attempting to 






Osteopathic Technique 13 

adjust vertebrae have done much harm to suffering 
humanity. I want to show later how the best results 
may be secured from Osteopathy, or mechanical treat- 
ment, with no danger of injury to the patient. 

The real lesion, or spinal abnormality, when it exists, 
is in a tightened vertebral joint or series of such joints. 
The ligaments binding such vertebrae together have 
become shortened. The inter-vertebral substance be- 
comes thinner and is frequently absent. In sorie cases 
it entirely disappears and ankylosis sets in. When a 
vertebral joint is not as free in its movements as it 
should be the adjacent microscopic tissues are involved 
and the flow of lymph and circulation in such struc- 
tures is impeded. For this reason we claim that the 
real spinal lesion is immobility of spinal joints. Other 
joints may be affected in much the same manner. 

For the above reasons we would be more explicit in 
giving caution to avoid harsh and severe treatment 
and to refrain from adjusting or attempting to adjust 
bones of the spine or pelvis unless we are positively 
certain that such apparent maladjustments are the 
cause of diseased conditions. 

It follows that the best treatment will be directed to 
loosen the tightened joint or joints and so manipulate 
the surrounding tissues that circulation will be restored. 
Chiropractors have been doing their work, using a 
theory that is entirely wrong, but In practice they have 
only loosened such joints, and in that way have se- 
cured good results. They would secure better results 
if they paid some attention to surrounding tissues. 

A Chiropractor performs his work by placing both 



14 Practice of Osteopathy- 

hands on a spinal vertebra, one over the other, enfor- 
cmg it, and giving a quick thrust. The patient is in the 
recumbent position, and this thrust is given with the 
idea of adjusting misplaced vertebrae; but the only 
effect is to secure more mobility of the joints. Were 
force used sufficient to move the vertebrae serious in- 
jury would result. This has proved to be the case re- 
sulting from some treatment given by both Chiroprac- 
tors and Osteopaths. Fig. No. 51 A illustrates the 
manner in which the Chiropractor thrust is delivered. 
Some have the elbow bent, and in straightening out the 
elbow the thrust is given. Other practitioners attempt 
to withdraw the hands after making the thrust to allow 
the vertebrae to recoil. 

The effect of working on a spinal articulation with 
sufficient force to loosen the joint, is to stimulate the 
segments of the spinal cord nearest that joint, and 
send nerve impulses in increasing numbers over the 
nerves that find their origin in that portion of the cord. 
This nerve stimulation will be caused by any mechani- 
cal force acting on the spinal column sufficient to in- 
fluence the cord. 

The circulation of the blood, both arterial and 
venous, must be kept free. Tightened, tense muscles 
and ligaments, various abdominal organs out of posi- 
tion, as in enteroptosis, interfere with the proper circu- 
lation of the blood, lymph and nerve impulses. This 
quickly leads to disease. For example, when the 
tissues tighten in the neck from any cause, circulation 
is obstructed and inflammation of the tonsils, pharynx, 
and other structures takes place. And on account of 



Osteopathic Technique 15 

the stagnation of the circulation, pathological germs 
find a lodging place and various diseases such as diph- 
theria, scarlet fever, etc., begin. When there is trouble 
with the ears, eyes, nose or throat we may be sure that 
there is interference with their blood and nerve supply 
somewhere, and oftentimes that obstruction is in a 
tense muscle or ligament. 

Spinal vertebrae, of course, are found out of position, 
but this is very seldom a cause of disease, unless such 
malposition is the result of a severe accident. Dis- 
placement of a vertebra sufficient to cause pressure on 
a nerve would be very serious, indeed, but is very 
rarely found. 

The founder of Osteopathy is very fond of claim- 
ing that " the Great Master Mechanic left nothing un- 
finished in the machinery of his masterpiece — Man — 
that is necessary for his comfort or longevity." But if 
spinal vetebrae are so easily misplaced as to cause pres- 
sure on nerves and blood vessels and thus cause dis- 
ease. Deity has made a mistake in designing his mas- 
terpiece — Man. 

The reader must not think from the above that I 
undervalue the good results to be obtained in Osteop- 
athy, or mechanical treatment, only to obtain better 
results than have been secured in the past we must 
perform our work with a view to loosen tight joints, 
relax muscles, ligaments and fascia, and not attempt to 
move bones that are not causing pathological condi- 
tions. Much good has been accomplished with the old 
theory as a basis, but where it has been carried to its 
logical conclusions harm has also resulted. 



16 Practice of Osteopathy 

All honor to the founder of Osteopathy, even if his 
theory was, in part, resting on false premises. 

Diagnosis, Methods of. The method of diagnosis 
most in vogue and the principal one which the" Os- 
teopath uses is palpation, the use of the hand or 
hands in determining the condition of nearly all 
the tissues of the body. With careful work and 
much practice, comparing the normal with the ab- 
normal, the sense of touch becomes very acute, 
and the least difference in the density and the 
motility of the various tissues is readily determined. 
The patient should be requested to relax all tissues 
as much as possible and not to make any resist- 
ance to the various movements unless requested 
so to do. The other methods of diagnosis are in- 
spection and percussion. With the beginner, in- 
spection is also important, as by it he notes curva- 
tures, unequal development of muscles, differences 
in the color of the skin, apparent age, height, 
weight, peculiarities of gait, manner of standing, 
sitting, etc. 

Percussion enables us to learn the condition, size, 
shape and position of various organs, the presence 
of cavities, gas, tumors, etc. This form of diag- 
nosis calls into use a small hammer, but more gener- 
ally the second and third fingers of the right hand 
are used to strike the middle finger of the left hand 
which has been placed over the part to be percussed. 
In examining a patient it may be well to begin with 
the neck. 

The important point in the diagnosis is to discover 



Osteopathic Technique 17 

the pliability and mobility of the spine. If it is too 
pliable there is danger of curvature. If portions of 
the spine are too stiff and there is not proper motion 
in the joints of the vertebrae it is a cause for disease. 
This may be determined, for the dorsal and lumbar 
portions of the spine, by examining as in 
Fig. 32; in the cervical region by examining as in- 
dicated in Figs. 14 and 15. The ease with which this 
movement is accomplished, together with a rotation 
of the head, determines the amount of pliability. By 
examining a few persons who are in health you 
can determine what the normal should be. 



18 Practice of Osteopathy 



EXAMINATION AND TREATMENT. 

In many of the descriptions of treatments which 
follow you might think that you were to put a bone 
into its proper position at once, but you will not, and 
it would not be best to do so. It often only results in 
making an articulation more pliable, which is the real 
object in view, looking to the ultimate result of restor- 
ing the patient's health. The utmost care must be 
taken not to injure a patient, which may be easily done 
in the case of a child or a weak person. 

Special Directions for Treating. In giving a gen- 
eral treatment, try to do the work in twenty min- 
utes. When you begin to practice Osteopathy it 
will take thirty minutes or longer to give the gen- 
eral treatment, but after you have practiced for a 
while you will feel that you are wasting time if you 
do not give it in twenty minutes or less. In using 
the shorter time you will do the work very effective- 
ly. In treating many cases you will obtain better re- 
sults to give a short and very specific treatment. 
Not more than five minutes is necessary for the en- 
tire operation. As the founder of Osteopathy used 
to say, " Do what is needed and then quit." He 
called those who spent time in going over the entire 
body " engine wipers." He wished Osteopaths to 
be mechanics, first-class engineers, and to fix what 
was wrong in a workmanlike manner. 



Osteopathic Technique 19 

In nervous troubles and in many constitutional 
diseases Osteopaths have discovered that they get 
better results when they give the general treatment. 
This helps the circulation and makes a tired patient 
feel like new ; and the treatment, after all, when 
there are no specific lesions to remove, is but little 
more than deep massage, in which nearly all the 
muscles of the body are manipulated. 

One may give this treatment, in such a manner that 
many patients come to look upon it as a luxury. And 
many will take it when they are only slightly indis- 
posed. Some business men take the treatment as a 
means of relaxation. Many others take it when they 
are simply tired. 

In acute cases the Osteopath treats every day and 
sometimes more often. When the patient becomes 
better three treatments, and then twice per week, will 
be sufficient. In treating chronic cases I have obtained 
good results by giving the treatment every day for a 
week and then treating three times per week. When 
the patient became better, treatment was given twice 
per week, later only once per week. In chronic cases 
I found it necessary to treat my patients for three to 
six months, though some did fairly well after one 
month's treatment. A number of cases I have found 
it necessary to treat from one to two years. That is 
a long time, but results justified the time spent. In 
treating such cases I have found it to be be-neficial 
to let the patient rest from the treatment for from 
one to three months and then begin treatment again. 
Some patients do not seem to improve for the first 



20 Practice of Osteopathy 

six months ; then they continue to improve until they 
are well. I have had patients who did not make any 
visible improvement in a year. They would quit the 
treatment and begin to improve from that time on. 
That is one reason why I have found it advisable to 
have patients rest from the treatments for a month or 
more. 

Office Examination. In outlining the examina- 
tion of patients in the office, where by far the great- 
er number of an Osteopath's patients are treated, I 
will give my own methods, which I tried in every 
way to simplify and was successful in doing so as 
time progressed. 

My reception room was well lighted and kept very 
clean. Everything about it was bright and cheerful. 
The hardwocKi floors were well covered with bright- 
colored Indian rugs. There were plenty of rockers. 
A good supply of up-to-date popular literature, in- 
cluding some bearing on Osteopathy, was always on 
hand. There was a good library of the latest medical 
works. 

There were four good-sized treating rooms in con- 
nection with the reception room. These contained a 
treating table, costumer, dresser with mirror at- 
tached, and a couch on which many of the patients 
rested after treatment. This added greatly to the 
benefit of the treatment in the cases of many nervous 
patients. For the ladies there were many full-length 
and full-fashioned kimonos, which were kept well 
laundered. In the treating rooms were running 



I 



Osteopathic Technique 21 

water and a good supply of towels and soap. The 
kimonos were open in the rear, which permitted of 
a thorough examination of the back, which I al- 
ways did on first treating the patient. The gen- 
tlemen were nearly always examined the first time 
on the naked back. They removed only the top 
shirt, and I lifted the undershirt when I wished to 
examine them. This permitted of a thorough exam- 
ination. 

The patient sitting, the examiner stands behind 
and notes any inequalities on either side of the neck. 
Sometimes one side bulges and on the other side 
there is a corresponding hollow. This condition 
indicates curvature in this region, with the con- 
vexity to the full side. On this side the tissues 
will be found to be hard, tense, and tender. When 
this condition is present it is frequently indic- 
ative of a curvature lower down. We now note 
whether there are enlarged tonsils, hypertrophied 
lymphatic glands, goiter, or any unusual pulsations 
or enlarged vessels. 

With the patient now reclining on the back in a 
comfortable position, with all muscles relaxed, we 
proceed with the examination by palpation. The 
neck may be gently manipulated by placing one 
hand on the forehead, for the purpose of rotating 
it by using the forehead as a lever, while the other 
hand manipulates the muscles in the back of the 
neck for the purpose of further relaxation. In ex- 
amination, as in treating, the Osteopath never rubs. 



22 Practice of Osteopathy 

He never allows the hand to slip on the skin, but 
is concerned with moving all the deeper tissues. 

The Osteopath now with the points of the fingers 
examines the tissues just beneath the skull. Often 
these are found tense, and the patient complains of 
pain here during examination and treatment. The 
fingers are now allowed to travel down the mid line 
at the back of the neck^ and find the spinous proc- 
esses. The first one to be felt beneath the skin 
is the second, or axis. The position of the first, or 
atlas, is rarely determined by the spinous process, 
though in some cases, about one in fifty, it may be 
found. We are able to count the vertebrae in this 
manner and to note their position. The seventh, or 
vertebra prominens, has a very prominent spinous 
process. It can be differentiated from the first dor- 
sal, the one just beneath it, by rotating the head 
when the patient is in a sitting position and noting 
that the spinous process of the seventh cervical 
moves perceptibly while the spinous process of the 
first dorsal does not move. 

Anterior, posterior, or lateral deviations may be 
determined by the examination of the spinous proc- 
esses. The position of the transverse processes 
may be noted by turning the head to one side, mov- 
ing the examining fingers up a little and to one side 
from the spinous process. A prominent projection 
will be found when the one on the other side will 
be found in the same manner and the fingers will 
then move down from one to the next process on 
both sides, determining the relative position of each 



Osteopathic Technique 23 

with reference to neighboring processes. This en- 
ables us to determine lateral deviations, twists, or 
torsions of vertebrae ; also posterior or anterior de- 
viations from the normal. 

Osteopathic treatment of the neck is for the pur- 
pose of removing lesions, which may consist of any 
departure from the normal in any tissue and which 
is causing abnormality of function. In following the 
description let us remember that all patients are not 
to be subjected to the same routine. This is too fre- 
quently done, to the detriment of the patient. What 
follows is for the purpose of describing the work in 
detail and to describe the work necessary for the 
removal of the various lesions usually found. This 
section of the book will be very frequently referred 
to by the numbered paragraphs where the descrip- 
tion of the specific treatment is referred to in the 
proper treatment of each disease. 

1. While the patient is in a sitting position on 
the side of the table, the operator, standing behind, 
the right hand placed on top of the patient's head, 
rotates the head so as to bring the neck of the pa- 
tient against the thumb of the operator's left hand. 
The left thumb is moved successively along against 
the arches of the vertebrae, as shown in Fig. 1. In 
this manner there is secured a free motion between 
the vertebrae, and the movement also assists in re- 
laxing the tissues preparatory to removing any ver- 
tebral lesion that may be present. 

2. The patient is sitting and the operator is stand- 
ing behind, and bends the neck of the patient as far 



24: Practice of Osteopathy 

forward as possible on the chest of the patient. 
This stretches the strong posterior neck muscles, 
including the ligamentum nuchse. 

3. The patient sitting, the operator stands in 
front and puts his arm about the neck of the patient, 
so that the bend of the elbow comes beneath the 
chin of the patient, and the hand grasping the base 
to the skull. The other hand is free to manipulate 
any of the vertebrae in any desired direction, though 
this hold is more applicable to the atlas and the axis. 
The head of the patient may be given a lifting 
motion and moved over in the required direction. 
See Fig. 3. 

4. The scaleni muscles, the deeper ones at the 
side of the neck, are often tight and contracted. 
Pressure may be made on the first rib on the con- 
tracted side, as in Fig. 4, while the other hand bends 
the head forcibly to the other side, at the same time 
rotating the head. 

5. The patient lies on his back. The operator 
stands at one side with one hand on the patient's 
forehead, the other beyond to the other side of the 
neck. The hand on the forehead rotates the head 
from side to side, alternately relaxing and stretch- 
ing the muscles at the side and back of the neck, 
while the hand placed at the side of the neck 
stretches the muscles toward the operator with each 
movement of the neck. The hand on the neck will 
be moved from one position to another as the tis- 
sues relax beneath it, and the hand may be brought 
down onto the shoulder during the process of re- 



Osteopathic Technique 25 

laxation. This same treatment may be applied to 
all the tissues in front of the neck down to the 
clavicles. See Fig-. 5. 

6. The hyoid bone may be found just above what 
is often called Adam's apple, the thyroid cartilage, 
the largest cartilage of the larynx. The bone feels 
as if it were shaped like the wishbone of a chicken, 
minus the protuberance at the angle. While it 
should be freely movable it is often held tight by 
the muscles, the supra hyoid and the infra hyoid, 
attached to it. This bone is frequently drawn back- 
ward and downward, and by pressure on nerves 
is the frequent cause of nervous coughing and may 
be responsible for complete loss of voice. By 
manipulating the neck from side to side the thumb 
and forefinger may be gradually insinuated under it, 
and it may be lifted up and forward. The tissues 
all about it should be thoroughly relaxed. See 
Fig. 6. 

7. The pneumogastric nerve may be pressed up- 
on, manipulated and stimulated by deep pressure be- 
hind the anterior border of the sternomastoid mus- 
cle on a level with Adam's apple, as in Fig. 7. This 
is a very important nerve, osteopathically, owing to 
its large distribution to important organs. 7 A. 
The spinal accessory and glosso-pharyngeal nerves 
may be reached by deep pressure upward and in- 
ward behind the angle of the jaw. 7 B. The sub- 
occipital, great occipital, small occipital, and great 
auricular nerves may be stimulated as in cases of 
fever, headaches, etc., by deep pressure on both 



26 Practice of Osteopathy 

sides of the spine, just at the base of the skull, as 
in Figs. 8 and 9. The founder of Osteopathy, Dr. 
A. T. Still, when but a small boy, made pressure 
on these nerves by placing his head in a swing. 
See Fig. 10. He found that this pressure relieved 
his headache. This accidental discovery may have had 
something to do with his discovery, later in life, 
of Osteopathy. 7 C. By deep pressure of the tissues 
of the neck against the transverse processes of the 
second and third cervical vertebrae we may stim- 
ulate the superior cervical ganglion. See Fig. 9 A. 

8. We will have occasion to refer to spring- 
ing the lower jaw by opening and closing the mouth 
against resistance. The operator stands behind the 
reclining patient, with hands under the chin and at 
both sides of the jaws of the patient, who is directed 
to open and close the mouth slowly, the operator 
resisting. This frees the tension of muscles and 
allows more freedom of blood vessels below the 
jaw. See Fig. 11. 8 B. In connection with the 
above the hands may be used to draw up the tissues 
under the chin. Let the movement be circular and 
deep. The points of the fingers are used to execute 
this movement. See Figs. 12 and 19. 

9. The head may now be twisted as far as 
possible to one side without causing inconvenience 
to the patient; then to the other side in the same 
manner. We often notice in executing this move- 
ment that it moves further to one side than to the 
other. On the side to which it turns the least we 



Osteopathic Technique 27 

look for muscular or ligamentous lesions. See 
Fig. 13. 

10. The head may be pushed as far forward as 
possible onto the chest, loosening the posterior 
muscles and other tissues far down the spine. See 
Figs. 14 and 15. 

11. Some operators can use a very effective 
spiral treatment of the tissues of the back of the 
neck. One hand is placed on the forehead of the 
reclining patient, the other beneath the neck. The 
neck and head are both raised. The head is rotated 
in one direction, the neck in the opposite direction. 
Then the movement is reversed. See Fig. 16. 

12. A number of movements have been devised 
fo reduce atlas lesions. One has been given above 
as in No. 3. These movements may be used in a 
slightly different way for the other cervical verte- 
brae. The operator stands at the head of the table, 
the patient reclining. The operator grSiSps the head 
firmly with both hands and makes pressure with 
the fingers against the arch of the atlas behind. He 
raises the head slightly, supporting it against the 
body. Now as he rotates the head he presses the 
bone toward the normal position. See Fig. 17. 

13. The neck tissues may be stretched as in Fig. 
18. In some cases it will be of material assistance, 
in the case of light patients, to have an assistant to 
hold the feet of the patient, to afford greater resist- 
ance. 

Many other movements in the treatment of the 
neck will be developed in the regular routine of 



28 Practice of Osteopathy 

practice by the skillful operator. This will be true 
of every portion of the anatomy as well as of the 
neck. 

THE HEAD. 

Most of the treatment for the purpose of affect- 
ing the head is given in the neck, upper dorsal and 
other portions of the body. Nevertheless the Oste- 
opath does some direct work on the head. 

14. While the patient is lying on the back the 
palms of the operator's hands are passed from the 
center of the forehead each way, with varying 
pressure down over the temples and behind the 
ears. This movement has a quieting effect on the 
patient, soothing the nerves, and is frequently used 
in headaches. It affects branches of the fifth nerve 
on the forehead. See Fig. 20. 

15. One palm is placed across the forehead and 
the other beneath the skull, or both palms may be 
placed on the forehead, one on top of the other, 
and great pressure exerted for a few seconds and 
repeated several times. See Fig. 21. This is useful 
in colds, headaches, etc., as it helps to relieve the 
pressure in the longitudinal and lateral sinuses, 
large veins of the brain. 

16. Treat along the midline of the skull, from 
the nose to the back of the neck, using the thumb 
in a circular, pressing motion with varying degrees 
of pressure for the same purpose as Nos. 14 and 15. 
See Fig. 22. 

17. We may tap with the knuckles or percuss 



Osteopathic Technique 29. 

with one finger laid upon the center of the forehead 
in treating headaches, colds, etc. 

18. Manipulate on each side of the nose and 
loosen all the tissues for the purpose of affecting 
the fifth nerve and freeing structures in close con- 
nection with it. See Fig. 23. 

19. Use deep pressure, with a gliding movement 
of the little finger, to work over a portion of the 
fifth nerve, supplying the tear duct, for the purpose 
of opening it or keeping it open. Begin at the 
inner corner of the eye. See Fig 24. 

20. The forefinger will find a little depression 
in the skull, just below the eyebrows, between the 
center and inner margins of the eye, where the 
supraorbital branch of the fifth nerve emerges 
from the skull. It is a nerve of nutrition to the eye, 
and passes outward over the forehead at an angle 
of forty-five degrees. Free the tissues about and 
in this little opening with a gentle, pressing, cir- 
cular movement of the tip of the forefinger. See 
Fig. 25. Work along the nerve with the palm 
of the thumb. In some cases of neuralgia it will 
be found to be extremely sensitive, which will be 
greatly lessened as tissues are relaxed about it. 
In treating the eyes this nerve is often stimulated. 
The nerve may be felt beneath the skin. 

21. The fifth nerve may be treated where it 
emerges from the skull above the eye, in Figs. 
25 and 20. Also over both jaws, above and below 
the roots of the teeth. It may also be treated below 
the malar cheek bones, as in Fig. 26. It may be 



I 



80 Practice of Osteopathy 

treated along the sides of the nose, as in Fig. 23. 
Thorough treatment of this nerve is frequently 
necessary in cases of neuralgia. 

THE EYES. 

22. The fingers must be very clean as they work 
inside of the orbit to tone up weak or contracted 
muscles in cases of strabismus. The finger may 
be inserted deeply, yet carefully, and worked around 
the eyeball, both to relax and free up the tissues 
and to promote a better circulation. 

23. The nail must be thoroughly clean as it is 
used to break up the little blood vessels which form 
a network running into the pterygia, which, if let 
alone, will grow towards and cover up the pupil of 
the eye. 

24. Granulations may be broken up by crushing 
them between the thumb and forefinger. For this 
purpose, folds of the lid may be lifted up, or one 
finger may be inserted beneath the lid. 

25. The patient, lying on the back, the eyeballs 
may be pressed back into the orbit several times 
with the palms of the thumbs and held there for a 
few seconds. This helps in toning up the various 
structures and assists in the general circulation of 
the eyes. 

26. The palm of one finger may be placed over 
the eyeball and tapped, as in percussion, by the 
forefinger of the other hand. This acts very much 
as No. 25, and is useful in cases of cataract. See 
Fig. 27. 



Osteopathic Technique 31 

THE SPINK 

27. The patient sits on the side of the table and 
the operator notices any deviation from the normal 
in exaggerated curves, lateral curvature, or any 
number of vertebras or a single vertebra which may 
be misplaced. He notes any tenderness, as he 
palpates with the fingers, that may be found in 
the tissues on either side of the spine or between 
the spinous processes. See Figs. 28 and 29 for 
fairly normal spines. 

28. The tips of the spines, the spinous processes, 
may be noted by the red color brought out on them 
by swiftly passing the hand over them with some 
pressure. In this manner their position may be 
noted, thus disclosing any deviation from the 
normal. 

29. A finger may be placed each side of the 
spinous processes and passed down, in this manner 
noting any lateral deviation from the normal. 
This may be done either on the bare spine or over 
the clothing worn in treating. See Fig. 30. 

30. The palm of the hand may be passed down 
rapidly, from the base of the skull to the sacrum, 
for the purpose of noting any deviations from the 
normal, either posterior or anterior. 

Pressure exerted on the top of the head, as in Fig. 
69, will frequently reveal tenderness at some point 
in the spine. 

31. The patient rests in the prone position, lying 
on his stomach, while the operator, with the palms 



32 Practice of Osteopathy 

of the fingers, notes contracted muscular tissues, 
pulling the muscles away from the spine on either 
side. These contracted muscles often feel like 
small ropes beneath the fingers. See Fig. 31. 

32. The limbs of the patient are flexed as he lies 
on his side, and the operator holds them in this 
position as he gently springs the spine, as in Fig. 
32, noting its relaxed or contracted condition. 

33. While the patient is lying on the side in a 
comfortable position the vertebra are carefully ex- 
amined by the fingers of the operator. Pressure 
is made between the spinous processes of each one, 
to note the condition of the ligaments and the ap- 
proximation or separation of the various vertebrae. 
See Fig. 33. When the ligaments have grown too 
thick they fill the spaces and produce what is 
known as the smooth, stiff spine. 

34. With the patient sitting on the side of the 
table, and the operator standing behind, he may be- 
gin the treatment of the back by placing the tips of 
his fingers on the patient's shoulders and with the 
thumbs loosen the muscular tissues in the upper 
part of the back. If the hands are long he can 
travel up and down a good portion of the back with 
the fingers in the above position. See Fig. 34. The 
fingers may now be used in relaxing all the tissues 
on the shoulders from the neck over the top of the 
shoulders. 

35. While the patient is sitting the operator 
passes one arm over one shoulder and under the 
opposite arm in front With the other hand he 



Osteopathic Technique 33 

makes fixed points on the spine with the thumb, 
against which he rotates the body with the other 
arm, and in this manner thoroughly loosens the 
structures and replaces misplaced vertebrae. See 
Figs. 35 and 36. The position is reversed and the 
other side of the spine is treated in the same 
manner. The patient may be held, as in Fig. 68, 
one shoulder braced against operator's body. 

36. The patient sitting, and the operator stand- 
ing behind places one hand on the top of the 
patient's head and with the other hand makes fixed 
points with the thumb along the spine, using the 
head and neck as a lever. The use of the hands 
may then be reversed and the other side of the spine 
treated in the same manner. The operator will be 
surprised with the efhciency of this movement and 
the power that can be exerted at any given point 
along the spine against the thumb by making the 
right pressure on the head. See Fig. 37. 

37. The patient sits, preferably on a stool, and 
places his hands behind his neck. The operator 
stands behind and passes his hands under the 
patient's arms and takes his wrists and places one 
side of the flat of his knee at the patient's spine and 
lifts the patient up and backward against the knee. 
This is an efficient treatment for loosening the 
various articulations and stretching the ligaments 
which have become tightened. It stretches the 
spinal, scapular and neck muscles. The lower ribs 
are raised. See Fig. 38. 

38. The patient sitting, the operator stands to 



34 Practice of Osteopathy 

one side and behind, or kneels beside the patient 
on the table, and passes one arm back of the 
patient's neck and under the patient's arm on the 
other side, thus bending the patient's neck forward. 
With the free hand fixed points are made along 
the spine and the patient's body is rotated against 
the thumb of the operator. This movement is 
very effective in upper dorsal regions. See Fig. 39. 

39. The patient sitting, the operator stands be- 
hind and places one knee beneath the arm of the 
patient in the axilla. This holds the shoulder and 
the ribs on that side in a fixed position. The 
operator may use one or both hands in raising one 
or more ribs or in stretching the opposite side. 
See Fig. 40. This may be used in combination with 
Figs. 46, 47. 

40. The patient is sitting, and the practitioner 
stands behind to one side and reaching around the 
patient in front grasps the lower edge of any rib. 
With the other free hand he raises the arm of the 
patient on the same side as he lifts the rib. This will 
be helped by having the patient take a deep breath 
as the rib and arm are raised, then holding both 
as the patient expels the air. See Fig. 41. 

41. The patient is sitting on a stool with the 
knees against the wall. The operator stands behind 
and places his knee on the appropriate round of 
the stool, with the knee against the vertebrae he 
wishes to correct, seizes the patient by the 
shoulders or under the arms and pulls the patient 
back against the knee, rotating the patient to make 



Osteopathic Technique 35 

the necessary correction of the spine. Extreme 
care must be exercised in executing this movement 
for fear of injury to the patient. See Fig. 42. 

42. The patient while sitting on the side of the 
table is bent forward so that his head is between his 
knees, the operator using forcible pressure on the 
upper dorsal region and head. This relaxes the 
ligaments of the lumbar and sacro-iliac regions. 
See Fig. 43. 

43. The patient is sitting on the side of the table. 
The operator is standing in front of the patient, 
with a pillow between himself and the patient. 
Both hands clasp the spine of the patient as in Fig. 
44, when deep pressure may be made, sinking the 
vertebrae well in ; then by rotating the body 
pressure may be made to the side wished. This is 
an excellent movement to correct a lateral curva- 
ture or any lateral or posterior displacement. In 
case of an anterior displaced vertebra the vertebrae 
above and below may be brought forward in this 
manner, thus gradually correcting the one which 
is anterior. 

44. The position is the same as in 43 for both 
operator and patient. By grasping the spine firmly 
on each side the patient may be lifted and the spine 
stretched, or correction may be made in this manner 
when only two or three vertebrae are approximated 
too closely. See Fig. 45. 

45. Fig. 46 shows an excellent movement in 
cases of spinal curvature. The side which is 
shortened may be stretched by using the wrist under 



36 Practice of Osteopathy 

the patient's arm, and the hand, as shown in the 
figure, raises and stretches the side. The other free 
hand moves from point to point along the spine 
and forces it over into position. 

46. The side may also be stretched, as in Fig. 47. 
Firm upward pressure may be made with the hand 
grasping the ribs while traction is made on the 
upstretched wrist of the patient. 

47. The patient lies in as easy a position as pos- 
sible, with the face downward, but for comfort the 
face may be turned to one side, with the toes ex- 
tending over the end of the table. Let the arms 
hang over the side of the table. Have the patient 
relax as much as possible. The operator uses the 
palms of the hands in a circular, pressing move- 
ment to relax all contracted tissues of the back. 
See Fig. 48. With the cushions of the fingers he can 
pull the muscles away from the spine, as in Fig. 31. 

48. With the patient lying in the prone position, 
the operator standing at one side of the table grasps 
the hip of the patient on the further side in front. 
The heel of the other hand can then travel up and 
down the spine, exerting considerable pressure 
while the other hand pulls the hip upward, giving 
the spine a torsion. The operator works from both 
sides. This movement is very effective in removing 
lesions and relaxing contracted tissues. See Fig. 
49. 

49. With Mie patient in the prone position, lying 
across the ta.aie as in Fig. 50, the opera-xvyi* stands 
at the head of the patient, and with th*^ tshumbs 



Osteopathic Technique 37 

working each side of the spine he can further re- 
lax tissues and stimulate the nerves through the 
spinal cord. 

50. With the patient in the prone position, and 
the operator standing at the head of the table with 
the thumbs each side of the spine, as in Fig. 51, he 
can further relax the tissues and can also exert con- 
siderable pressure when necessary to correct poster- 
ior displaced vertebrae, or for the purpose of 
stimulating the spinal cord and through it the organ 
or organs which receive their nerve supply from 
any particular section of the spinal cord. 

51. The patient is in the prone position, and the 
limbs are raised in the operator's arm, as in Fig. 52, 
and rotated while the other hand makes fixed points 
with considerable pressure on the lower part of the 
spine. 

52. The patient is in the prone position, and 
pressure is made in the lower part of the spine, 
while first one then the other limb is raised, as in 
Fig. 53. This movement, as well as No. 51, assists 
the operator in relaxing the tissues and replacing 
posterior vertebrae. 

53. The patient lies on his side in a comfortable 
position. The operator stands in front and grasps 
the patient's uppermost arm, as in Fig. 54. With 
the other hand he relaxes the tissues about the 
shoulders and down to the spine and pretty well 
down the back, using the arm as he holds it at the 
elbow as a lever, working it back and forth to aid 
in the manipulation. The spine is manipulated 



38 Practice of Osteopathy 

and any deviations are corrected at the same time 
and in the same manner. 

54. The tissues may be so relaxed that the 
shoulder may be manipulated quite freely. One 
hand may pull up the scapulae, while the other 
presses on the shoulder, as in Fig. 55. The hand 
may also be insinuated under the scapulae, as in 
Fig. 56, and the tissues thoroughly manipulated 
and loosened. 

55. While the patient is reclining on the side, 
and one hand has made its way under the patient's 
scapulae, the other hand grasps the patient on the 
shoulder and rotates the entire shoulder. See Fig, 
57. 

56. The patient is lying on his side on the table. 
The operator places one hand beneath the patient's 
neck and grasps the occiput, as in Fig. 58. The 
operator brings his chest against the other side of 
the patient's head. In this manner considerable 
traction may be made on the neck and upper dorsal 
region, and very effective corrective work may be 
done with the spine with the free hand as shown in 
the cut. 

57. The limbs of the patient may be flexed and 
braced against the operator, who bends over and 
grasps the spine thus brought into relief, as in Fig. 
32. The spine at any point may now be manipulated 
by pulling it toward the operator. 

58. With one elbow on the hip, the other on 
the shoulder, as in Fig. 59, as the patient is lying 
on the side, the operator's arms may be extended, 



I 



Osteopathic Technique 39 

thus stretching the hip away from the shoulder 
while the hands are free to manipulate tissues and 
the spine as well. 

59. The patient lies on the side, and the opera- 
tor, with one hand in front of the hip and the other 
hand behind the shoulder as in Fig. 60. By pulling 
on the shoulder and pushing against the hip the 
spine may be twisted for the purpose of relaxing 
tissues, including muscles, nerves and ligaments. 
With the same motion the side of the back upper- 
most may be stretched by separation of the opera- 
tor's arms. 

60. Fig. 61 is the exact opposite of the above, 
and the torsion is applied by reversing the position 
and motion. This is very useful for stretching 
and relaxing the various tissues of the back and 
spine. 

61. The patient lies comfortably on his back. 
The elbow of the patient is held by the operator 
with one hand, while with the other he reaches 
across the body of the patient and grasps the 
muscles of the back, as in Fig. 62. The arm may 
be stretched as movements are made to loosen the 
tissues manipulated with the free hand. The spine 
may also be manipulated with the free hand its 
entire length. 

62. The patient lies on the back, and the operator 
stands at the side of the table and reaches across 
the body of the patient and grasps the spinal edge 
of the scapulae, pulling it out as he brings the arm 
of the patient across the chest, as in Fig. 63. 



40 Practice of Osteopathy 

63o A small patient lies on the back. The knees 
are grasped in one hand and flexed, as in Fig. 64. 
The free hand is introduced under the patient, 
grasping the lower part of the spine and manipulat- 
ing it as the knees are made to describe a circle. 
This is a very thorough method of manipulating 
the lower dorsal and lumbar regions of the spine. 

64. The patient lies on the back. The knees are 
flexed on the thighs and the thighs are brought 
forcibly against the abdomen. The pressure may 
be relaxed, then increased. This movement relaxes 
the ligaments and muscles of the lumbar and sacro- 
iliac regions. See Fig. 65. 

65. The fifth lumbar vertebra is frequently found 
posterior. With the patient on his back, the 
clinched fist of the operator is placed under the 
vertebrae and one limb at a time is taken by the 
ankle and forcibly put through the motion of ex- 
ternal circumduction, straightening the limb out 
with considerable force, thus bringing the weight 
of the body on the vertebra. 

66. In case the fifth lumbar vertebra is anter- 
ior the lesion is more difficult to reduce. The liga- 
ments may be loosened, as in Nos. 63 and 64, and 
the vertebra moved from side to side, as in Nos. 
35 and 57, thus gradually bringing it into its prop- 
per position. 

67. In case we desire strong inhibition, for the 
purpose of lessening the number of nerve impulses 
passing from any section of the cord to any given 
organs, we may hold the spine with a strong grip, 



Osteopathic Technique 41 

partially liftin*g the body from the table, as in 
Fig. 32; or we may place a book under the spine, 
requesting the patient to recline heavily upon it, 
as in Fig. 66. The position of the book, as indicated 
in the cut, is for the purpose of quieting the peris- 
taltic action of the bowels in cases of excessive 
diarrhoea. 

68. When the sacrum is found to be posterior 
it may be moved to its proper position in many 
cases by properly relaxing the sacro-iliac ligaments 
as in Nos. 47, 51, 52, 64. Then have the patient lie 
on the side of the table. The operator then places 
his knee against the sacrum and pulls back on the 
hip and shoulder, thus gradually forcing the sacrum 
into position. See Fig. 67. 

69. Another movement for restoring to its proper 
position a posterior sacrum is for the patient to sit 
on a stool. The operator places his knee against 
the sacrum, and holding the patient about the body 
rotates it as he pulls it backward, thus bringing 
pressure to bear on the sacrum. See Fig. 42. 

70. The coccyx is frequently misplaced. It can 
be manipulated after relaxing the tissues about it. 
Frequently it is found necessary to insert the fore- 
finger into the rectum, when the coccyx may be 
grasped by the thumb and finger and moved in 
the desired direction. This latter treatment should 
not be given oftener than once per week, and must 
be carefully done for fear of injuring the delicate 
tissues. 

71. The finger, anointed with vaseline, is inserted 



42 Practice of Osteopathy 

into the rectum for various purposes by the Oste- 
opath. In doing so, time must be given for the 
sphincter muscle to relax. In piles, the finger 
presses the blood out of the congested veins, and 
with a circular, sweeping motion with the palm 
of the finger smooths out, frees and stimulates the 
action of nerves and blood vessels. In case the 
rectum is prolapsed it may be pushed up into posi- 
tion. 

72. The clavicle, or collar bone, is frequently 
found displaced. The sternal end, when out of posi- 
tion, affects the tissues of the throat and is a promi- 
nent factor in diseases affecting this region, in- 
cluding goiter and circulatory and nerve disturb- 
ances in the arms. The operator stands at the side 
of the table and takes the elbow of the patient, who 
is reclining, and inserts the fingers of the other 
hand under and above the clavicle, near the sternal 
end. The elbow is now brought over the breast 
of the patient and the fingers inserted more deeply 
under the clavical. This movement brings heavy 
pressure onto the fingers by the clavical, which re- 
sults in raising the latter, when the sternal end 
can be placed in or toward its normal position. 
See Fig. 70. This treatment may be applied at 
either end of the clavicle as the case may require. 

73. The clavicle may also be raised and placed 
in its normal position with the patient sitting, as 
in Fig. 71. The elbow is grasped and raised, which 
raises the clavicle, when the thumb may be inserted 
above and under it. By bringing the elbow upward 



Osteopathic Technique 43 

and across the chest the clavicular ligaments may 
be stretched and the clavicle properly replaced. 
This treatment is effective for either end of the 
clavicle. 

THE THORAX. 

In treating the thorax we must remember that 
the ribs are connected with the vertebrae, and that 
when the spine has a curvature, or one or more 
vertebrae are twisted or displaced in any manner, 
the ribs connected with those vertebrae are very 
frequently misplaced as a result. These combined 
lesions cause secondary lesions of the muscles, 
ligaments and cartilages. In correcting any malad- 
justment of the ribs advantage is taken of the mus- 
cles attached to them, especially the pectoral and 
latissimus dorsi muscles. 

74. The vertebral end, or head of the rib, is nearly 
a fixed point. Pressure exerted at the angle of the 
rib tends to move the rib about that fixed point. 
This movement is made more effective by the forci- 
ble elevation of the arm and in some cases by the 
rotation of the shoulder. 

75. The first rib is often raised near the sternal 
end. It may be depressed after the scaleni, the 
muscles of the neck, are thoroughly loosened. It 
may be depressed by pressure as the operator stands 
behind the sitting patient, as in Fig. 4. The head is 
bent forward and rotated, as in the cut. This 
stretches the scaleni muscles attached to the rib. 
The pressure is still appHed as the head is turned 
toward the rib. 



44 Practice of Osteopathy 

76. The first rib may be also corrected as the 
patient is in the recumbent position, as in Fig. 72. 
The head is raised and rotated away from the rib, 
while the pressure is applied to the rib. Later the 
head is rotated toward the rib as the pressure is 
again applied. 

77. A further treatment for the first rib is applied 
as the patient is in the recumbent position, as in 
Fig. 72. With the head turned toward the affected 
rib and slightly elevated, pressure is made on the 
rib with the thumb, and the elbow on the same side 
is grasped and carried across the chest to the 
opposite shoulder. 

78. When the first or second rib is displaced 
downward it can be raised ; the patient sitting, 
the operator standing behind. The operator places 
the tips of the fingers at the lower border of the 
rib and lifts on it as he rotates the head, with the 
free hand, forward and then strongly backward. 
This uses the neck muscles, the scaleni, to pull 
the rib upward. Should the anterior cartilages 
protrude they may be pressed into position as 
the above treatment is being given. 

79. Should the first and second ribs need elevat- 
ing, nearer the spine, the operator may stand in front 
of the sitting patient while he presses and lifts up . 
near the head of these ribs, while he rotates the 
head forward and to the opposite side with con- 
siderable force. See Fig. 73. 

80. The first rib may be depressed, with the 
operator sitting at the side of the patient with the 



Osteopathic Technique 45 

patient's arm across the operator's shoulder. This 
elevates the structures on that side. Pressure is 
now made on the upper border of the rib, just above 
the clavicle, as the head is rotated to that side and 
forward. See Fig. 74. 

81. The practitioner stands in front of the sitting 
patient. One arm reaches around the patient, a 
little past the spine to the angle of the ribs, as in 
Fig. 47, while the arm of the patient is raised on 
the same side. The arm is stretched up and rotated 
back and down while the operator lifts on the angle 
of the rib. This serves to lift the rib in front as well 
as at the angle, because of the traction exerted on 
the pectoral muscles in front by the elevation of the 
arm. This motion should be carefully executed, 
yet sufficient strength should be used to make it 
effective. It may be repeated several times if 
necessary. The hand which holds the ribs may 
select one after another, as may be necessary, as 
the arm is stretched and rotated. In giving the 
above treatment the muscles, nerves, and ligaments 
are strengthened and toned. If one rib is very 
much lower than it should be the patient should 
take a full breath when the rib is pulled up, and as 
the breath is expelled the rib is still held for a few 
seconds. 

82. Fig. 46 represents another method of elevat- 
ing and separating ribs. The patient sits and the 
operator stands in front. The operator forces the 
spine to the side in question, which helps to separate 
the ribs. The arm of the patient is raised by the 



46 Practice of Osteopathy 

wrist on that side, which raises the ribs. A com- 
bination of 81 and 82 is frequently effective. 

83. The patient sitting and the arm of the 
patient across the shoulder of the operator, as in 
Fig. 75. This gives more of a hold on the lower 
rib while the patient's head is bent away from the 
side being treated, curving the spine and throwing 
the rib more into relief. 

84. The patient sits on a stool and the operator 
stands behind, with his knee against the angle of 
the rib. With one hand the operator elevates and 
rotates the arm of the patient, and with the fingers 
of the other hand, beneath the rib in front, lifts upon 
it as the patient takes a deep breath. The entire 
treatment may be reversed and the rib depressed. 
See Fig. 41. 

85. The patient is sitting. The operator standing 
in front grasps the head of the rib in question, with 
one hand passed about the patient, while the other 
hand presses on the sternal end of the rib. By 
rotating the body of the patient the rib may be 
sprung into position. 

86. The patient is reclining on the back. The 
operator, standing to one side, reaches over and 
takes the arm of the patient on the other side. With 
the free hand he takes the rib at or near the angle, 
as in Fig. 62, and as he pushes it into place he 
lifts up on the outstretched arm and rotates it 
backward. This calls into play the anterior muscles 
attached to the rib or ribs and assists in the move- 
ment. The patient may further assist the operator 



Osteopathic Technique 47 

by taking a deep, full breath as the rib is lifted up, 
which the operator holds for a few seconds as the 
breath is exhaled. 

87. The patient may lie on the side. The 
operator uses the same general movements as in 
No. 86. This of course applies more to the upper 
ribs. 

88. As the patient lies in the prone position the 
heads or angles of the ribs may be replaced, as in 
Figs. 76, 50, 51, by working directly over them. 

89. When the patient lies in the prone position 
many cases of luxated ribs may be treated by pres- 
sure of the thumbs against the angles of the ribs, 
throwing the ribs either upward or downward, as 
indicated by the needs of the condition. 

THE ELEVENTH AND TWELFTH RIBS. 

90. These ribs are very frequently found dis- 
placed. The surrounding tissues must be fully 
relaxed. When the rib or ribs are displaced upward 
we have the patient lie on the side, with the limbs 
flexed on the abdomen, when the ribs may be 
grasped by the operator and pushed into position, 
forcing them upward. 

91. The patient sits on the side of the table, 
while the operator holds each end of the rib. The 
patient takes a full breath, and as the patient ex- 
hales, the rib is pushed into position. 

92. When the rib is displaced upwards the 
patient takes either position, lying on the side or 



48 Practice of Osteopathy 

sitting, and the rib is manipulated, as in Nos. 90 
and 92, only in the opposite direction. 

93. Frequently we find the ribs flattened over the 
liver or stomach. They may be pulled out, as in 
Fig. 77 . Then they may be rounded into shape 
by using pressure on the ribs at the sides, as in 
Fig. 78. Repeated treatment in this manner will 
materially affect their shape. 

In treating and manipulating affected ribs or 
misplaced ribs we find it necessary to repeat the 
treatment. In some cases it takes considerable 
time, a number of treatments being necessary for 
permanent results. The ribs are so prone to slip 
back into their old positions when they have been 
out of position for a long tim-e. 

THE ABDOMEN. 

The Osteopath in examining the abdomen uses 
inspection, percussion and palpation. The latter 
conveys the most information concerning the con- 
dition of this important region and its contents. 
We note displacements of various organs, new 
growths, tumors, relaxed or tense conditions of 
the muscles, differences in temperature, enlarged 
or pulsating vessels, muscular contractions, dis- 
tended or contracted walls, etc. 

94. A general treatment of the abdomen is fre- 
quently very helpful, either for relaxing or toning 
muscular tissues, for increasing or decreasing the 
amount of blood in the abdominal vessels, and for 
its general effect on the nerves. The patient lies 



Osteopathic Technique 49 

on the back, with the knees flexed. The operator 
stands at one side of the table, and with the palm 
of the hand, not the tips of the fingers, relaxes the 
muscles of the abdomen. The operator may begin 
low down to one side and work up on that side, then 
on the other side in the same manner. The ribs may 
be slightly sprung inward to assist in the relaxation 
of the abdominal walls as they are undergoing 
manipulation, as in Fig. 79, which shows the general 
position of the hands. The abdomen may be 
spanned by the hands, with the thumbs on one 
side and the finger tips on the other side, and the 
abdominal contents moved in this manner from one 
side to the other. 

95. In treating any part of the body, but es- 
pecially the abdomen, the hands should be of such a 
temperature as not to be disagreeable to the patient. 
Cold hands used here will cause a contraction of 
the tissues, and thus interfere with the work. Direct 
pressure may be made with the flat of the hand, 
as in Fig. 80, over the center of the abdomen well 
below the umbilicus. Pressure may be gradually 
increased, with some side pressure to force the con- 
tents of the small intestine toward the caecum, the 
lower part of the large intestine which lies low down 
on the right side. 

96. It is often advantageous to lift up the intes- 
tines, as in Fig. 81. With the patient reclining, the 
knees should be flexed to allow of more thorough 
relaxation of the abdominal muscles. This move- 
ment should be repeated several times and the 



50 Practice of Osteopathy 

abdominal contents held for a minute or so each 
time. 

97. The patient is sitting, and the operator is 
standing behind. He places the sides of the palms 
of the hands deeply beneath the abdominal contents, 
as in Fig. 82. The patient is requested to bend 
forward as the operator twists his wrists, so that 
the sides of the hand next to the patient are turned 
inward and upward. Then request the patient to 
straighten up as the operator lifts the contents, 
and holds for a moment. 

98. The patient lies on the side, permitting a 
relaxed condition of the abdominal walls. The 
operator stands behind, as in Fig. 83, and lifts the 
abdominal contents upward, and may also lift them 
toward the median line, thus straightening out the 
caecum, or sigmoid flexure, as the position may 
allow. 

99. The operator may straighten out the sigmoid, 
and at the same time tone up the muscular tissues, 
by insinuating the palms of the hands deeply and low 
down on the left of the abdomen, and suddenly 
lifting the contents. The movement must be care- 
fully and cautiously performed. 

100. It is often of advantage, as will be indicated 
in various treatments, to tone up the solar plexus. 
This may be done by deep steady pressure, with a 
slightly circular motion just below the sternum. 
Pressure should be directed backward and upward, 
as in Fig. 84. 

101. The liver, spleen, and stomach and other 



Osteopathic Technique 51 

upper abdominal viscera may be toned by placing 
one hand on either side of the ribs, as in Fig. 85. 
Pressure, alternating with a few seconds of rest, is 
made as indicated. 

102. The liver and adjacent abdominal viscera 
may be toned by alternating pressure and relaxa- 
tion directly over that organ, as indicated in Fig. 
78. 

103. The gall bladder lies underneath the ante- 
rior portion of the liver, just beneath the points 
of the ninth and tenth ribs on the right side. The 
bile duct leaves it at this point and proceeds to 
the duodenum, in the shape of a reversed letter " S '' 
when it enters that portion of the small intestine, 
about one and a half inches below the umbilicus. In 
cases of gallstones, or inflammation of the bladder or 
duct, we may assist nature in emptying the bladder 
and pass stones along the duct by manipulation. 

THE PELVIS. 

In the treatment of diseases peculiar to women, 
and some diseases peculiar to men, lesions of the 
pelvis play a most important part. One may never 
expect to effect a cure while these lesions are permitted 
to remain. To remove them is of the greatest import- 
ance. 

Pelvic lesions will also be considered here because 
they affect the limbs, causing sciatica, paralysis, en- 
larged veins, errors in circulation, etc. These lesions 
are often accompanied by spinal lesions, which al- 
so affect the spine and through it other internal 



52 Practice of Osteopathy 

organs. The discovery of these lesions requires 
considerable anatomical skill, and an attempt to 
correct lesions here should only be made when the 
operator is absolutely sure of his diagnosis. 

The whole pelvis may be tipped backward, in 
which case the superior posterior iliac spines will 
be found to be too prominent. In case the whole 
pelvis is on a torsion, one side back, the other side 
forward, one superior posterior iliac spine will be 
found prominent and the other less prominent than 
normal. In case one side of the pelvis is higher than 
the other, the superior posterior spine will be higher 
on the high side. The limb on the high side will be 
shorter than the limb on the low side. This may be 
determined by slightly manipulating both limbs to 
relax all tissues, and then comparing the internal 
malleoli of the tibia with each other. This may be 
done by placing them close together. Another way 
is to have the patient hold a tape line between the 
front teeth, and measure to the anterior superior 
spines of both ilia, and also to each internal malleo- 
lus of each tibia. In case the upper portion of the 
pelvis has moved forward, the superior posterior 
iliac spines will be found to be less prominent than 
in the normal pelvis. 

In making the examination the operator will best 
determine the condition by having the back bare. 
Great care must be exercised in making the examina- 
tion. The points of tenderness in case of luxation 
will be found over the sacro-iliac articulation, both 



i 



Osteopathic Technique 53 

in the muscles and in the ligaments, interfering with 
nerves in the same region. 

104. When the pelvis is tipped backward have the 
patient sit on a stool or table. The operator stands 
behind and places his knee against the upper part of 
the sacrum, while he takes the patient beneath the 
arms and pulls upward and backward on the trunk 
with a rotary motion to first one side and then the 
other. The assistant sits in front and draws the 
pelvis forward. See Fig. 42. 

105. For backward tipping of the pelvis the pa- 
tient may recline on the table with the face down. 
With one hand the operator makes pressure on the 
upper part of the pelvis, while he lifts the limb on 
that side with considerable force. This treatment 
is given first on one side then the other. 

106. For a backward tipping of the pelvis the 
patient lies on the side on the table. The operator 
stands behind. The knee is placed firmly against the 
sacrum, and the shoulder and the leg are both drawn 
backward. This forces the pelvis forward. See 
Fig. 67. 

107. When the pelvis is tipped forward the patient 
may lie on the side. The operator stands behind, 
and as he presses against the lower part of the sa- 
crum and pelvis with one hand he pulls back with 
the other hand from the upper part of the front of 
the pelvis, the anterior superior spine of the ilium. 

108. The patient sits on a stool, while the operator 
stands in front. The assistant is stationed behind 
the patient and holds the pelvis in front and draws 



54 Practice of Osteopathy 

it backward, while the operator with his arms under 
those of the patient manipulates the body of the 
patient forward with a lifting, rotary motion. 

109. Should the pelvis tip upward on one side, 
the quadratus lumborum muscle may be stretched, 
as in Figs. 59, 60, 61. Then No. 108 may be applied, 
with the assistant holding down the high side of 
the pelvis. 

INNOMINATE LESIONS. 

We frequently have lesions which affect only one 
side of the pelvis. We often find one of the innomi- 
nates backward and downward at the same time; 
again one will be upward and forward. The former 
will lengthen the limb on the same side, the latter 
will shorten it. These lesions are the most common, 
but we may find their exact reverse. We may find 
both innominates luxated in different ways or in 
similar ways at the same time. 

In order to determine these lesions we must de^ 
pend on the position of the posterior superior iliac 
spines as indicated in lesions of the whole pelvis. 
We must compare the length of the limbs. Make 
measurements between the coracoids of the scapulae 
and the anterior superior spines of the ilium. Look 
for tension and tenderness in the sacro-iliac liga- 
ments ; also at the pubic symphysis. Examine the 
lumbar region of the spine for curvature or torsion. 
Compare the waist lines. We may measure also 
from the teeth to ilium and to the internal malleoli. 
See Figs. 86 and 87. 



Osteopathic Technique 55 

110. When the innominate is luxated backward 
have the patient He on the back. The operator places 
his fist beneath the posterior superior spine of the 
ilium. The other hand grasps the ankle and flexes the 
limb on the patient's abdomen, when the limb is rotated 
outward and downward with considerable force. 
In this manner the weight of the patient helps to 
force the innominate into position. 

111. The operator may grasp the crest of the 
ilium, and also the tuberosity of the ischium, and by 
alternately pushing on the one and pulling on the 
other may set either a forward or backward luxa- 
tion. This is done with the patient either lying on 
the back or on the side. 

112. Combinations of the above movements, 110, 
111, or the work used in correcting the whole 
pelvis, may be used in correcting any lesion of an 
innominate. 

THE LIMBS. 

The general treatment of the limbs may be modi- 
fied in various ways for the treatment of different 
and definite lesions. 

113. The limb may have various tissues relaxed 
preliminary to other work, by manipulating the 
various tissues by seizing the limb in both hands, 
as in Fig. 88, and with a rotary movement of the 
hands move and relax all the tissues to the bones. 

114. Both internal and external rotation and 
circumduction of the limb may be performed, flexing 
the calf of the leg on the thigh and the thigh on 



56 Practice of Osteopathy 

the abdomen, then straightening the limb out with 
the proper rotation, with more or less force. See 
Fig. 89. 

115. The sciatic nerve may be stretched by ex- 
tending the limb, as in Fig. 90, at the same time 
bearing down considerably on the foot. 

116. The patient reclining, the knee may be 
slightly flexed and the operator works under it with 
both hands, stretching the muscles outward and 
working in quite deeply. See Fig. 91. 

117. The foot may be flexed, extended and 
rotated with considerable force on the ankle. Liga- 
ments and other tissues are thus relaxed and the 
circulation is promoted. See Fig. 92. 

118. In treating the feet the arches may be 
sprung to increase the arch, and pressure and trac- 
tion may also be applied to it. This relaxes liga- 
ments, permits of replacing misplaced small bones 
and tones up the muscular structures of the foot. 
See Fig. 93. 

119. The toes may be stretched and rotated with 
force at the same time. In some cases they must 
be handled with care. The treatment assists in the 
circulation by freeing all tissues, nerves and blood 
vessels. 

120. The saphenous opening, through which the 
long saphenous vein passes, lies one or two inches 
below the lower end of Poupart's ligament, on the 
inner side of the thigh. This opening is often prac- 
tically closed by tense muscles. It may be made 
free by external and internal rotation of the limb, as 



Osteopathic Technique 57 

in Fig. 89. Then the opening itself may be manipu- 
lated. 

121. The extended limb may be seized by the 
foot when the patient is in the reclining position, 
and turned outward as far as is comfortable for the 
patient, then be allowed to come to its normal posi- 
tion, See Fig. 94. This may be done, say ten times. 
Then it may be turned inward the same number of 
times. This movement puts the muscles on a strain 
by torsion, tones them up and assists in the cir- 
culation. 

Old subluxations cause considerable trouble. A 
slight misplacement at the hip is often treated as 
disease of the knee, neuritis, etc. These misplace- 
ments are not always discovered by the ordinary 
physician, but when the real cause is removed the 
case is cured. Reducing these luxations, when the 
case is an old one, requires a course of treatment 
to relax all muscular tissues, to render the parts 
flexible and the ligaments more pliable. 

122. When we discover that the hip is dis- 
located, with the head of the femur up and back 
on the dorsum of the ilium, in which the limb is 
short and the toes turned inward, we flex the knee 
and rotate it inward. This frees the head of the 
femur. Then we rotate outward and make exten- 
sion while we press on the great trochanter to 
force the head into the acetabulum. See Fig. 95. 
This luxation comprises one half of all hip dislo- 
cations. 

123. The head of the femur is sometim^es down 



58 Practice of Osteopathy 

and back near the sciatic notch. This also shortens 
the limb and turns the toes inward. The treat- 
ment is the same as above, as one writer puts it, 
"bend up, turn in, roll out and extend." Use one 
hand to manipulate the great trochanter. See 
Fig. 95. 

124. Sometimes there is a thyroid dislocation 
of the hip, in which the head has been forced down- 
ward into the obturator foramen. In this case the 
knee is flexed and the toe points either inward or 
outward. To make the proper reduction the leg 
is flexed on the thigh and the thigh on the pelvis. 
The knee is rotated inward as far as possible, 
followed by extension. Pressure is made at the 
same time to force the head of the bone into its 
proper position. See Fig. 95. 

125. When the head of the femur is forward 
and onto the pubis the toe turns outward. The head 
of the bone can be felt and seen. Treat as in No. 
124. Should this prove unsuccessful place the 
patient on the side and draw the limb backward 
with considerable force, stretching all the muscles 
about the head of the bone ; then lift the head over 
the pubis and place it in its proper position. 

126. Ankle dislocations are reduced by simple 
traction. The knee is flexed on the thigh, the thigh 
on the pelvis. An assistant holds the knee and the 
operator holds and pulls the foot, giving it at the 
same time a slight rocking motion. See Fig. 96. 

127. Dislocations of the knee are reduced by strong 
traction. Pressure to force the tissues into plac^ 



Osteopathic Technique 59 

may be made at the same time. The knee joint 
may be sprung by placing arm under the knee and 
pressing down on foot. See Fig. 97. 

128. In treating the shoulder and arm the 
shoulder may be rotated as in Fig. 57. The opera- 
tor grasps it before and behind the shoulder. 

129. The shoulder joint may be sprung, as in 
Fig. 98. The forearm of the operator is placed in 
the axilla, and the arm of the patient pushed toward 
the side. This relaxes tissues and frees up the cir- 
culation. It may be freed of adhesions and the 
circulation promoted by seizing the wrist, bringing 
it back and up under axilla and stretching out in 
front with force. See Figs. 103, 104. 

130. The elbow may be flexed on the same prin- 
ciple as indicated as in No. 129, by placing the 
clenched fist of the operator on the patient's arm 
just above the elbow and bending the arm upon 
the hand so placed. See Fig. 99. 

131. In some cases it is well to work carefully 
down the arm, rotating the muscles on the bones 
and working carefully on the forearm between the 
bones. See Figs. 103 and 104. Fig. 105 represents 
the stretching of the long head of the biceps, after 
which the arm will be flexed and the tendon pressed 
into its groove. 

132. All dislocations of the shoulder may be 
reduced by having the patient recline. The opera- 
tor places his stockinged foot in the axilla and makes 
strong traction on the arm of the patient. The 



60 Practice of Osteopathy 

knee may be used instead of the foot, as in Fig. 
100. 

133. In cases of elbow dislocations, where both 
bones are displaced backwards or displaced exter- 
nally or internally, or the ulna is backwards, the op- 
erator places his knee in front of the elbow joint, 
pressing against the ulna and the radius with the 
knee and bends the forearm. This plan uses the mus- 
cles to pull the bones into place. When the radius is 
backward the above or simple pressure, with ma- 
nipulation, may be used. For forward dislocation 
bend the elbow over the knee. Use extension and 
manipulation. See Fig. 101. 

134. The various wrist dislocations are all re- 
duced by traction. Some manipulations may be 
used. 

135. Should the ulna be dislocated at the wrist, 
pressure will be sufficient. 

136. For the various dislocations of the hand 
use pressure, traction and rotation. 

In many cases of old dislocations a prolonged 
course of treatment is necessary. 

137. A table and stool are represented in Fig. 
102. The stool is fourteen inches square on top 
and twenty-one inches high. The table is a folding 
one with a steel frame and thin wood top. It 
can be carried easily to the patient's home. One 
for regular office use would be padded and more 
substantial in design. The table represented in 
the cut is five feet and ten inches long, and twenty 
inches wide and twenty-six inches high. 



Osteopathic Technique 61 

138. A General Treatment is given by a great 
many Osteopaths in connection with the specific 
treatment needed for the ailment for which the pa- 
tient is being treated. General treatment is an advan- 
tage in a number of cases. It is given for nerve 
troubles and for the general circulation. The treat- 
ments will vary greatly with different Osteopaths 
but the following is a sample : 

139. The patient reclines on a table, lying on his 
side. The Osteopath begins by loosening up the 
tissues of the back, as indicated in Nos. 53, 56, 58. 
The shoulder is manipulated, as in Nos. 54, 55, 
the lower limb as in No. 113. The spine is 
sprung from one end to the other, as in No. 57. 
The patient then lies on the other side and the 
treatment is given as before. The patient then 
takes the reclining position, when further treat- 
ment is given the back as in Nos. 47, 48, 50, 51, 52. 

Afterward the patient lies on the back and the 
treatment is commenced at the head, as in Nos. 
14, 15. 

The neck is treated as in Nos. 7B, 9, 10, 11, 13. 
The arms are treated as in Nos. 130, 131. 

Further treatment is given the back, and the ribs 
are raised as in Nos. 61, 62, 86, 64. The abdomen 
is treated as in Nos. 94, 95, 96, 100, 101, 102. The 
lower limbs are treated as in Nos. 113, 114, 115, 
116, 121. The patient now sits on the side of the 
table and the back and spine are further treated 
as in Nos. 1, 2, 5, 34, 36, 37, 43, 44. 



62 Practice of Osteopathy 

140. A treatment that has come Into use, recently 
among Osteopaths, is shown in Fig. No. 108. It is 
spreading the ischia. If. is used in casejof enlarged 
prostate gland. The founder of Dsteopathy claims 
that spreading these bones invariably helps this 
condition. 

In sciatica, the pyrafomis muscle which crosses 
the sciatic nerve is frequently contracted and causes 
pressure on this nerve. This muscle may be 
stretched by forcibly carrying one leg over the other 
as seen in figure No. 90B,. 

The muscles and other structures of the leg may 
be stretched as indicated in figure No. 88A. This 
movement helps to reduce contractions and assists 
circulation in the lower limbs. The muscles in the 
anterior portion of the leg may be stretched by ex- 
tending the limb as in figure 89B. 

A good method of raising the ribs Is illustrated in 
figures 47A and 77A. In the first mentioned il- 
lustration we see by holding and stretching the arm 
upward we bring into play the pectoralis major and 
minor muscles which help in raising the ribs. In 
figure 77A it will be well to have the patient elevate 
his arms and while he lowers them to spread and 
raise the ribs. This movement acts in stretching 
the diaphragm which is attached to the ribs. An- 
other method is illustrated in figure 76A. 

Figure 69A represents closing and spreading the 
knees against resistance. 

In figure 29A we have represented an abnormal 
spine. This patient suffered a severe attack of ty- 



Osteopathic Technique 63 

phold fever, and was very badly constipated. No- 
tice the lateral swerve, but what is worse the an- 
terior condition of two lumbar vertebra. 



64 Practice of Osteopathy 

THE SPINE. 

The spine, in its normal condition, is a chain 
of flexible nature. It is formed of a number of 
bones called vertebrae, from the Latin vertere, to 
turn. There are thirty-three of these vertebrae, 
of v^hich seven are in the cervical, or neck 
region, twelve are in the dorsal region, which oc- 
cupies the space from the neck to where the small 
of the back begins, five are in the lumbar region, 
the small of the back to the sacrum, five are in the 
sacral and four in the coccygeal region, which is 
the coccyx. The twenty-four upper vertebrae 
should remain separate and flexible through life. 
Those in the sacral and coccygeal region, in the 
adult are firmly united and form two bones, the 
sacrum and coccyx. 

The spine has four normal curves, the cervical, 
dorsal, lumbar, and pelvic. The first, or cervical, 
extends from the base of the skull to the second 
dorsal vertebra. This curves inward. The dorsal 
curve extends from the second dorsal vertebra 
to the first lumbar vertebra. This is an outward 
curve. The lumbar curve extends from the first 
lumbar to the sacrum. This curve is a forward 
one. The sacral curve begins at the union of the 
last lumbar vertebra with the sacrum and extends 
to the tip of the coccyx. This is an outward curve. 

In very young children the cervical and lumbar 
curves are absent, and when the child is sitting the 
spine presents only one curve from the base of the 



Osteopathic Technique 65 

skull to the end of the spine, and this curvature is 
an outward one. The cervical and lumbar curves 
are called compensatory, and develop a little later. 
The curves of the normal spine should be frequent- 
ly examined, until the operator has a good idea 
of the normal spine. He should be acquainted 
with the normal flexibility of the spine as well. 




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DISEASE AND ITS 
TREATMENT 

SPINAL CURVATURE. 
(Scoliosis.) 

We frequently find very serious cases of spinal 
curvature which may be cured or greatly benefited 
by Osteopathic treatment. There must be a process 
of building up muscles and ligaments, of restoring 
and strengthening wasted parts. At the same time 
other muscles and ligaments must be relaxed. 
Where the spine is ankylosed, that is, where the 
vertebrae have practically grown together, it can not 
be straightened but a false ankylosis, due to rigid- 
ity of the surrounding parts, may be straightened, 
where there is a curvature. 

The operator should remember that nearly all 
spines have a little lateral curvature in the dorsal 
region, and in right-handed persons this curvature 
is directed to the right, and in the case of left- 
handed individuals the curvature bends toward the 
left. The more muscular a person is and the more 
the arms are used the more pronounced will we 
find this curvature. This is due to over-developed 
muscles pulling the spine to one side. This will 



190 Practice of Osteopathy- 

be true of numerous occupations which tend to 
develop one side of the body more than the other. 
For this reason we always ought to know the occu- 
pation of the patient and use this information in 
determining the form and force of treatment needed. 

Of course if both sides are equally developed 
muscularly there will be no lateral deviation of the 
spine. In some cases of spinal curvature, in addi- 
tion to the Osteopathic treatment, it will be well to 
give the patient some muscular exercises to develop 
the muscles on the concave side of the curvature, 
and thus help to straighten the spine. 

There are three forms of spinal curvature, or 
scoliosis : Functional, which is the result of faulty 
positions, assumed as a habit or occupation, or as 
a result of a Aveak eye or ear. It may also be caused 
by some deformity in some other part of the body. 
This often appears before the age of ten. There are 
no pronounced symptoms and it is often discovered 
accidentally. One of my cases had been under 
treatment for a number of years, by a regular physi- 
cian, for various troubles, when her mother, in giv- 
ing a bath, discovered a severe case of spinal 
curvature. This first class of spinal curvature may 
be easily cured but if left, it becomes Transitional 
curvature, when the case is progressing into what 
is called Structural curvature, in which the shape of 
the vertebrse is changed. On account of this change 
in the structure and shape of the bones which form 
the spinal column such a case is very difficult to 
cure. This type of curvature is not only caused 



Disease and Its Treatment 191 

by neglected functional cases, but may have begun 
before birth and is congenital. Rickets, arthritis 
deformans, infantile paralysis and pathological af- 
fections of the vertebrae act as a cause. 

Many cases require a long course of treatment. 
A great deal of preliminary work must be done. 
Where the tissues are contracted in the back they 
must be loosened by some of the treatments, as 
Nos. 34, 36, 44, 43, 58, 59, 60. The vertebrae must 
be frequently worked over into their proper posi- 
tion. See Nos. 45, 57, 38, 39. It is often well to 
begin at the lower vertebra that is out of position, 
and force it over, then the next and so on up the 
spine as far as the curvature extends. Do not 
attempt to do too much at a time, but it will be 
necessary in most cases to continue the work for 
from one to three years, treating most of the time 
from two to three times per week. Special attention 
must be paid to the ribs in many cases. See the 
examination and treatment of the ribs. 

In cases where the spine is too flexible it may be 
necessary to use appropriate exercises to strengthen 
the spinal muscles. They may be worked over and 
manipulated, as in Nos. 47, 31. 

In many cases of Pott's disease, where the de- 
structive processes have ceased and left the spine 
in a very stiff condition, much can be done to cor- 
rect the deformity and to restore the health. 

If one wishes to be better informed on this sub- 
ject it will be well to secure Lovett's work on 
" Lateral Curvature of the Spine." Many cases of 



192 Practice of Osteopathy 

structural curvature require some form of casts or 
braces to hold improvement gained, and this book 
enters into detail respecting the treatment. 



Disease and Its Treatment 193 



THE BACK. 

Kyphosis. This is a curvature of the spine 
directed backwards. We find this condition in many 
elderly persons, in persons who are naturally weak, 
and in children who have the rickets. We must 
distinguish this condition from the sharp angle 
of Pott's disease. 

The treatment will be given as indicated in Nos. 
34, 43, 37, 35, 38, 50. It will be necessary to give 
the treatment for some time twice per week ; later 
once per week will do. In elderly people we may 
not expect to straighten the spine to a marked 
degree, but the work will greatly improve the 
health, by securing a better blood supply to the 
spinal cord. 

Lordosis. This is an exaggerated curvature of 
the lumbar region, the curve of which is directed 
forward. It is frequently seen in women who have 
had frequent pregnancies and those who have drop- 
sy. The treatment is directed to strengthening the 
ligaments and muscles and the gradual correction 
of the curvature. See Nos. 64, 57, 63. Also see 
kyphosis. 



194 Practice of Osteopathy 

RIGID SPINE. 

This is a chronic inflammation of the spine in 
which there is pain of a varying nature. There is rig- 
idity and deformity. The intervertebral disks atro- 
phy and firm, bony unions form between the ver- 
tebrae, which gradually extend to the whole spine. 
The muscles atrophy and there is a forward bending 
of the whole spine. The pain varies greatly and 
in some cases amounts to a severe neuralgia. This 
is caused by the pressure of the vertebrae on the 
nerve roots, which they are allowed to do on ac- 
count of the absence of the intervertebral disks. 

This disease is caused by violent injury to the 
spine, from falls, blows and carrying heavy bur- 
dens when too young. Gonorrhoeal infections and 
articular rheumatism act as causes. 

When the spine has grown quite rigid from 
ankylosis I have failed to loosen the joints, but the 
treatment has built up the muscular tissue and has 
helped in overcoming pain. In cases where such 
bony union had not taken place it could be pre- 
vented and the case cured. The treatment consisted 
in a thorough spinal manipulation three times per 
week, with a general treatment. See general treat- 
ment. One case in which a number of vertebrae 
had become ankylosed I sent where three Osteo- 
paths could treat him at one time. He was very 
strong and could stand heroic treatment. The ver- 
tebrae were loosened in thirty treatments, and after 
following up this treatment for some months, at 
intervals, a good cure was effected. 



Disease and Its Treatment 195 



OSTEOMALACIA. 

Mollities Ossium. 

This is a disease in which pain first appears in 
the bones, and is at first often mistaken for rheu- 
matism. The bones gradually soften, later bend 
and easily fracture. Some writers claim that it is 
a disease of adults of from twenty to forty years of 
age. But I have treated very marked cases in chil- 
dren and young persons under twenty. When it 
occurs in older women it is thought that child- 
bearing is an exciting cause, as the first signs of the 
disease often appear during pregnancy. 

The symptoms begin with pain in the back of the 
neck, thighs and sacral region. Then weakness 
develops in the legs, so that the person desires help 
fn walking. After the deformity appears in the 
lower limbs there is danger of spontaneous fracture. 
There is a peculiar, uncertain, wabbling gait. The 
pelvis will be found to be deformed. Later the 
whole skeleton is deformed. Some writers claim 
that the urine has an excess of calcium salts. 

^ In cases that I have treated Osteopathically the 
disease was arrested and the patients enjoyed a fair 
degree of health afterward. The cause of the dis- 
ease is uncertain, and why the disease was arrested 
under treatment I can only conjecture. A normal 



196 Practice of Osteopathy 

nerve and blood supply was secured to all parts. 
A general treatment was given as far as possible. 
See general treatment. In only one case was any 
deformity corrected — that of the lower legs. 

Many cases are bedridden. They die from gen- 
eral debility and pneumonia. Much can be accom- 
plished by the use of good food, pure air and baths. 



Disease and Its Treatment 197 



^STVO-AUTUMNAL FEVER. 
(Bilious Remittent and Typho-Malarial.) 

This type of fever occurs in temperate climates, 
chiefly in the late summer and autumn. We find 
the more severe forms in the Southern States and in 
tropical countries. There may be a tired, weak feel- 
ing with a running off at the bowels for a few days 
before the appearance of the fever. The symptoms 
are very irregular. The paroxysms of fever average 
above twenty hours, instead of ten or twelve as in 
malarial fever. It may be distinguished from ty- 
phoid fever by the sudden rise and fall of the tem- 
perature at varying intervals. There may or 
may not be a chill after the first preliminary weak- 
ness. The urine is highly colored. There may be 
jaundice. The tongue is furred and heavily coated. 
There is vomiting, in which there is very much 
bilious matter. The patient looks very ill. 

The treatment should be a general one (see gen- 
eral treatment) paying considerable attention to the 
upper lumbar region and the entire dorsal. Treat 
two or three times per day until the patient is much 
better ; then once a week for a while. 



198 Practice of Osteopathy 



TYPHOID FEVER. 

Typhoid fever is an infectious, variable disease, 
caused by the bacillus of Eberth. This bacillus 
maintains its existence for one or two weeks in 
water. It multiplies in water and milk, and in these 
mediums it has been conveyed into the human 
system, causing the disease. The bacillus may live 
for months in the soil and in ice, as freezing does 
not kill it, but it may be destroyed by boiling for 
from fifteen to thirty minutes. Persons with spines 
which are stiff and in a posterior position in the 
lumbar region are predisposed to this disease. 
This condition of spine weakens, through the nerve 
supply, the lymphatics and drainage of the bowels 
and creates a lodging place for the proliferation and 
development of these disease-producing germs. 

The first stage of the fever comes on gradually. 
There is oftentimes a general feeling of ill health 
for some time prior to the more pronounced symp- 
toms. There may be nosebleed, sense of chilliness, 
slight fever, backache, sore throat. The fever rises 
day by day, each succeeding day higher than the day 
before, until in four or five days the highest is reached. 



Disease and Its Treatment 199 

The highest will be 103 to 105 degrees. The 
tongue is furred. There is no appetite. Constipa- 
tion is present, though it may alternate with 
diarrhcea. The pulse is 90 to 110 per minute. The 
patient is thirsty. There is headache and the skin 
is hot and dry. 

The secondary stage of the disease begins on the 
fifth day and lasts about two weeks. The general 
symptoms are more marked, the fever is high and 
continued, the pulse is faster and the headache 
disappears, "but there is mental dullness and there 
may be delirium. The abdomen is tender, and 
about the eighth day rose-colored spots appear on 
the trunk. The second week of this period is the 
most dangerous, but varies with the severity of the 
case. Complications may now set in, as lobar 
pneumonia, perforations and peritonitis. 

If the disease is following a favorable course the 
stage of decline in the fever begins on or about the 
twenty-first day of the disease. The symptoms 
begin to disappear and the temperature drops each 
day about one degree until the normal is reached. 

In the treatment of this disease we must be very 
careful that the utmost cleanliness prevails. The 
stools, urine, vomit and sputum should be treated 
with a five per cent solution of carbolic acid in order 
to destroy the bacilli-. All clothes should be 
changed daily and treated to a dip in the same solu- 
tion, after which they should be boiled for half 
an hour. During an epidemic it will be well for all 
water and milk to be boiled, especially that used 



200 Practice of Osteopathy 

for drinking purposes. All foodstuffs should be 
carefully cleaned. 

Typhoid fever to a certain degree is contagious, 
and it is advisable to keep the rest of the family, 
as far as possible, away from the patient. The bed 
should have a rubber sheet beneath the linen or 
cotton sheet, and the patient should be in a well- 
aired, sunny room. The patient should not arise 
from the bed, so a bed pan and urinal are absolutely 
necessary. The mouth should be washed two or 
three times daily with a three per cent solution of boric 
acid. The throat may be occasionally sprayed with 
the same. When the lips, mouth and tongue are 
parched they may be moistened with equal parts 
of glycerine and water. In case there is danger 
of bedsores the back, hips and heels may be 
moistened with dilute alcohol in which there is a 
mixture of alum and salt. Afterwards dust the 
parts with talcum powder or boracic acid powder. 
The diet should be liquid. The principal part of 
it should be milk. It may be diluted with water 
or with lime water. A feeding of milk would be 
four ounces, diluted with two ounces of lime water. 
This may be given every four hours. Albumen 
water may be given every four hours, which makes 
the time of feeding every two hours. In making 
the albumen water the whites of one or two eggs 
may be used and about the same amount of water. 
It may suit the taste of the patient better if the 
juice of half a lemon or orange be added or it may 
be flavored with vanilla. Sometimes the milk may 



Disease and Its Treatment 201 

be flavored with a little tea, coffee or brandy. A 
small cup of coffee may be given to the patient in 
the morning. Buttermilk or peptonized milk may 
be substituted if the milk can not be taken or the 
milk is not properly digested. Allov^ the patient 
all the ice water he wants. As much strong lemon- 
ade may be given as the patient may desire, but 
use very little sugar in it. As an agreeable change 
a cup of bouillon or strained vegetable soup may 
be given. Ice cream may be given. 

When the fever subsides the greatest care must 
be exercised in the diet, as a return to solid food 
at too early a date may result in a serious relapse. 
It is unsafe to allow any solid food for ten days 
after the temperature has become normal. The 
intestines are in a greatly weakened condition, 
ulcers have not healed and perforations may result 
from the ingestion of solid food. The diet should 
be gradually changed, still using the milk until it 
is replaced by solid food. The following may be 
gradually and carefully introduced : Mutton or 
chicken broth, junket, a very small piece of cream 
or milk toast, baked custard, strained vegetable 
soup, wine jelly, the soft parts of three or four 
oysters, meat soup thickened with egg, blancmange, 
calves' foot jelly, chicken jelly. Two or three of 
the above articles of food may be allowed daily 
with the milk. 

Treatment. Osteopathic treatment may be ad- 
ministered with very gratifying results. If begun 
early the fever may often be aborted. If it is begun 



202 Practice of Osteopathy 

later the disease shows favorable symptoms im- 
mediately. The musculature of the back should be 
thoroughly but gently loosened. See Nos. 61, 62, 
32, 53. The spine may be gently sprung from the 
lower part to between the shoulders. See Nos. 
57, 61. The tissues in the neck must be relaxed 
and treatment administered in the suboccipital 
fossae, just beneath the skull either side of the spine. 
See Nos. 5, 7, 9, 11, 13. Work in the lower part of 
the back helps to regain control of the circulation 
in the abdomen where the typhoid bacilli are at 
work. See No. 61. There must be no manipulation 
of the abdomen. This treatment or a portion of 
it may be given two or three times per day with 
great benefit to the patient. 

Give strict attention to diet, bathing and the 
above treatment, and many of the bad after effects 
of the disease will be overcome. The drug treat- 
ment has been left out of this article, as drugs sap 
the vitality of the patient and do no good. The 
greatest living authority among the medical doctors 
of today says, " A great many of my cases do not 
receive a single dose." 

The use of water, both externally and internally, 
has been found to be very beneficial, in its effects 
on the nervous system, the kidneys, the heart, and 
decreasing the liability to bedsores. It also assists 
in the reduction of the fever. 

In using the cold pack the patient is placed in a 
sheet wrung out of water at a temperature of 65 
degrees, The water may afterwards be sprinkled 



Disease and Its Treatment 203 

on the sheet. This treatment may be prolonged 
for twenty minutes or more at a time. 

In using the cold sponge bath a piece of gauze or 
old toweling is better than a sponge. One portion 
of the body may be bathed and dried at a time, be- 
ginning with the head. The water may be as near 
ice-cold as the patient can stand it. Twenty 
minutes or more should be consumed in giving the 
bath, and it should be thoroughly done. 

When the temperature is 102 or more the patient 
may be placed in the full bath, with the tempera- 
ture at eighty degrees. This should gradually be 
reduced to seventy degrees. If the bath is given 
in an ordinary bath tub canvas supports should be 
arranged to comfortably support the patient in the 
water, every part being covered but the head. The 
patient may remain in the water for fifteen minutes, 
unless there are signs of his being too cold, when he 
should be removed. A little stimulant and food 
should be given after the bath. While the patient 
is in the water the limbs and trunk should be 
thoroughly rubbed. When taken out wrap the 
patient in a sheet and cover with a blanket. 

Should constipation be present an enema should 
be given every third day. 

MALARIAL FEVER. 
(Ague, Chills and Fever.) 

This is an infectious disease, in which there is 
fever every second, third or fourth day. Sometimes 



204 Practice of Osteopathy 

there is a continuous fever, with remissions. The 
disease is caused by a specific microorganism, 
often transmitted to man by the bite of a mosquito. 

The preventative treatment calls for protection 
from mosquitoes. Have the house well screened. 
Have all marshes, ponds, and all stagnant water 
drained. In the malarial season petroleum should 
be used freely on all stagnant water. This kills 
the larvae of the pest. 

Marked bony lesions are found oftentimes in per- 
sons suffering from the disease. Great improve- 
ment follows their correction. A thorough spinal 
treatment, giving special attention to the portions 
between the shoulders and the center of the back, 
should be given. See Nos. 1, 2, 4, 5, 34, 35, 36, 37, 
43, 44, 47, 48, 50. The abdominal treatment should 
be given with vigor, as it assists in equalizing the 
circulation. A general treatment may be given. 
See general treatment. 

Osier claims that quinine is a specific for the 
disease, and recommends that a person going to 
a malarial district should take ten grains of quinine 
daily. When the fever is present he recommends 
twenty or thirty grains daily for the first three days, 
to be given in divided doses, and then continue in 
smaller doses for the next two or three weeks. He 
further recommends that quinine should be given 
every spring and fall for several years afterwards. 
Others claim good results from the administration 
of two or three grains of quinine three times per 
day. Quinine pills and tablets are not recommend- 



Disease and Its Treatment 205 

ed, but it should be taken in either a capsule or in 
solution. 

SCARLET FEVER. 

Scarlet fever is an acute, infectious disease with 
a general scarlet eruption, with high fever and sore 
throat. 

The fever begins from two tO' four days after 
exposure to the disease, though it may be from 
one to seven days. The fever may reach 104 to 
105 degrees on the first day. The eruption may be 
seen on the second day, though sometimes it ap- 
pears on the first day. The skin is dry and very 
hot, tongue furred, throat is dry and face flushed. 

The rash is scattered, red points on a red flushed 
background, appearing first on the neck and chest 
and spreading rapidly to the entire body. At its 
height it is a bright scarlet. This persists for five 
or six days and then the skin begins to scale off. 
This period lasts from eight to twenty days. 

Treatment. The patient should be carefully iso- 
lated and when possible other children should be 
sent from home. The disease can not be cut short. 
The bowels should be kept open and a light diet 
of broths, milk and fresh fruit should be given. Let 
the room be well ventilated. As the patient gets 
better, the fever becoming lower, the diet may be 
increased, but milk should largely predominate to 
avoid the danger of Bright's disease, which some- 
times attacks the patient when convalescence is 
well under way. When the skin begins to scale 



206 Practice of Osteopathy 

off it should be thoroughly rubbed with sweet oil 
or carbolized vaseline each day. 

Should the fever reach 103 a sponge bath is in- 
dicated. If the fever be higher the child may be 
placed in a warm bath and the water gradually 
reduced in temperature to 80 degrees. When there 
is delirium present a cold pack is very beneficial. 
A rubber sheet is placed on a thick layer of blank- 
ets, a sheet is wrung out of cold water and the child 
wrapped in it and wrapped in the blankets. The 
cold water may be renewed from time to time. An 
ice cap should be applied to the head when the 
fever is high. None of this is necessary unless the 
fever is high. A thorough relaxation of the muscles 
and other tissues of the back and neck will be very 
helpful. See Nos. 5, 10, 13, 14, 31, 47, 50, 53. 

LA GRIPPE. 

La grippe is a very contagious disease. It 
spreads with remarkable rapidity, and the symptoms 
begin in from one to four days after exposure. It 
begins abruptly with fever and a profound feeling 
of prostration. 

The majority of cases begin with a cold in the 
head, with a profuse discharge from the nostrils. 
After these catarrhal symptoms bronchitis may set 
in and the fever increase. There is a tendency to 
pneumonia, which is a very dangerous complica- 
tion. In some cases the catarrhal symptoms are 
absent, but there is pain in the joints, headache, and 
backache in the lumbar region. In other cases 



Disease and Its Treatment 207 

there are severe stomach and intestinal symptoms 
with vomiting, pain in the abdomen and diarrhoea. 

In some epidemics many patients have as a com- 
plication heart trouble (pericarditis and endocardi- 
tis). If there is a weakness in any part of the body 
it is apt to be augmented by la grippe. 

Treatment. A warm bath should be given and 
the patient placed in a warm bed and confined there 
until the fever has entirely left. An enema, in 
which there is a tablespoon of salt to a quart of 
water, should be given and the patient instructed 
to retain it as long as possible. If this cannot be done 
either Epsom or Rochelle salts should be given. 
Some medical authors advise a grain of calomel to 
be taken, one-fourth of a grain each hour until 
the grain has been taken. Then the salts should 
be taken after this, say about six hours. 

The neck and back on palpation will be found to 
be very tender, and a thorough osteopathic treat- 
ment will be the best possible treatment. It pre- 
vents all of the many complications, such as heart 
trouble and pneumonia, and quickly reduces the 
fever. In cases the author has handled the patients 
were usually at their accustonied vocations in two 
to three days, while the ordinary run of cases were 
being kept in from ten days to two weeks under 
the ordinary treatment. The neck tissues are to be 
thoroughly loosened. See Nos. 1, 4, 5, 9, 10, 11, 13. 
The tissues of the back must be relaxed. See Nos. 
34, 36, 37, 38, 40, 43, 47, 50. Give strong stimula- 
tive treatment for the fever at the base of the skull 



208 Practice of Osteopathy 

in suboccipital fossse. See No. 7. Stimulate in 
the upper dorsal region as in Nos. 50, 53, 56. Raise 
the ribs. See Nos. 81, 82, 84, 86. Work over the 
abdomen as in Nos. 94, 95, 100. The treatment 
should be given two or three times per day at first, 
and as the fever subsides and the patient is better, 
once per day will be sufficient. When the fever is 
high an ice bag should be applied to the head. The 
food should be liquid and nourishing. 

CHICKEN POX. 
(Varicella.) 

Chicken pox is an acute, contagious disease. It 
is characterized by a papular eruption, commen- 
cing with a sHght fever and a feeling of illness. The 
temperature may reach 103. The papules soon be- 
come vesicles and may be umbilicated as in small 
pox, holding a cloudy or clear fluid. These dry and 
form a crust, which drops off, leaving no scar. In 
severe cases when the true skin is involved scars 
may remain. 

The eruption in chicken pox first occurs on the 
trunk and neck, not on the forehead and face. The 
vesicles break easily and form successive crops, so 
that papule, vesicle and crust may be seen in the 
same locality at the same time. The papules do 
not feel like small shot and do not disappear on 
pressure. After exposure the attack may be ex- 
pected in from fourteen to sixteen days. 

Treatment. The bowels should be kept open. A 
warm bath should be given when the eruptions 



Diseasp and Its Treatment 200 

first appear. Avoid taking cold. Should the itch- 
ing prove troublesom-e apply carbolized vaseline. 
Keep the skin clean and do not allow infants to 
scratch. If the eruption is troublesome use a wash 
of a two per cent solution of chlorate of potas- 
sium. Apply cold cream to the vulva if necessary. 

SMALL POX. 
(Variola.) 

Small pox is an acute, contagious and infectious 
disease. In from nine to fifteen days, generally 
twelve days, after exposure, the patient may be 
seized with a chill, which may be repeated during 
twenty-four hours. Children sometimes have con- 
vulsions as an initial symptom. Headache, pain 
in the lower part of the back, and vomiting are com- 
mon, while the fever rises to 103 or 104. If the 
fever runs high there may be delirium and a flushed 
face, with clear bright eyes. In other cases there 
may be sweats. The symptoms are not always 
constant, but vary in the extreme. 

Accompanying the fever there may be a red rash 
resembling that of scarlet fever. In other cases 
it may assume a macular or measly form. In some 
cases it may be altogether absent. 

Usually on the fourth day macules begin to 
appear on the forehead, and within twenty-four 
hours may be seen on the face and other parts of 
the body. There may be quite a few on the upper 
part of the back, the hands and feet. They are a 
bright red color and disappear on pressure. They 



210 Practice of Osteopathy 

feel as if a small shot was hidden beneath the 
skin. On the fifth or sixth day these papules 
change to vesicles. The summits are clear, elevated 
and circular, with a small depression in the center, 
termed an umbilication. These change on the 
eighth or ninth day to pustules. They become more 
elevated and the depression disappears, and the 
appearance is a grayish-yellow from the contained 
pus. 

The skin about the pustules becomes red and 
swollen. There is a painful pulling sensation in 
the face, and the eyelids in a severe case are closed. 

The secondary fever arises and the first symp- 
toms return, but the fever does not remain high 
longer than twenty-four hours. In many cases it 
is entirely absent. The pustules dry rapidly in 
the order of their coming and form scabs. 

The small pox patient has a very peculiar odor, 
which is a help in diagnosing doubtful cases. 

Confluent Small Pox. The symptoms are the 
same as above but of much greater severity. The 
macules are set closer together. They are more 
abundant on the face, hands and legs. The temper- 
ature does not entirely leave after the breaking out 
and when the change is made to pustules the tem- 
perature rises to 103 to 104 with the pulse from 110 
to 120. The pustules have a tendency to run to- 
gether and to form large superficial abscesses. 

Haemorrhagic Small Pox. In this form the blood 
runs into the eruptions and is a very da-ngeroiis 
type of the disease. Its severity depends largely 



Disease and Its Treatment 211 

on the early appearance of this symptom. If it ap- 
pears later in the disease there is much less danger. 

Varioloid is not a different disease, but is a very 
modified form of small pox. Even in mild cases 
the early symptoms may be severe. The fever may 
rise to 103, The papules appear on the third or 
fourth day and the fever drops and does not again 
appear. The patient feels well and the papules and 
vesicles begin to disappear with the drop in the 
fever. 

Treatment. Drugs should not be given to reduce 
the fever, as they greatly weaken and depress the 
patient. When the temperature is high, a cold 
sponge bath may be given and an ice bag applied 
to the head. The diet should be light, mostly fluid, 
consisting mostly of milk and soups. When there 
is no fever, poached or soft-boiled eggs and toast 
may be added to the diet, with either tea or coffee. 

A gauze mask may be worn on the face, kept 
moist with cold water containing mercuric bichloride 
enough to make a 1 to 5,000 solution. When the 
crusts form they should be kept moist with vase- 
line. The eyes should be kept clean with a salt or 
boric acid solution. More than enough boric acid 
crystals than will dissolve may be kept in the water 
for this purpose. The mucous lining of the nose 
should be kept moist with vaseline. 

If the patient is constipated a salt water enema 
should be given every other day. At the onset of 
the disease, if no other treatment is available, a 
thorough purge with calomel may be taken. A half 



212 Practice of Osteopathy 

grain in one-tenth grain doses at intervals of an 
hour should be sufficient, in ordinary cases. Bed 
clothes should be soaked in a 1 to 4,000 solution of 
mercuric chloride, before going through the 
laundry. 

All surplus furniture, such as rugs, curtains, etc., 
should be removed from the room. 

CEREBRO-SPINAL FEVER. 

(Malignant Purpuric Fever. Cerebro Spinal Men- 
ingitis, Petichial Fever, Spotted Fever.) 

This is an infectious disease, caused by a specific 
microorganism, the diplococcus introcellularis. The 
coverings of the brain and spinal cord (cerebro- 
spinal meninges) are afifected. The course of the 
disease is very irregular. There is severe headache, 
pain in the back and upper part of the spine, con- 
traction of the muscles in the back of the neck, and 
delirium. 

There is a malignant type of this disease which 
proves rapidly fatal. It comes on suddenly with 
violent headache, chills, muscular spasms, light fever, 
but slow pulse, being 50 to 60 per minute. A purple 
rash may develop slightly raised places on the skin 
which fills with dark blood. 

The common form sets in suddenly, usually be- 
tween noon and midnight, with a chill. There may 
be convulsions with headache. There is pain in 
the back of the neck and sensitiveness to light and 
noise. There is great rigidity of spinal muscles and 
loss of control of bladder and rectum. There are con- 



Disease and Its Treatment 213 

vulsions, delirium and set eyes. The skin has va- 
rious symptoms. Sometimes a dusty mottling may be 
present, again rose-colored spots, as in typhoid 
fever. A purple rash, as spoken of above, may 
appear. The disease may last from a few hours to 
several months. Favorable symptoms of the dis- 
ease are apparant when the temperature falls. Mus- 
cles become less rigid and intelligence returns. 

There is an abortive type which sets in as above, 
but the case begins to improve in a day or two and 
the patient is soon well. 

Treatment. Use an ice bag or an ice coil on the 
head. Use warm mustard baths for the feet and 
cold sponge baths for the rest of the body. An 
enema of salt water should be given daily, using 
a tablespoonful of salt to a quart of water. If 
vomiting distresses, one drop of tincture of iodine, 
in sweetened peppermint water, may be given every 
two hours. Let the food be liquid or semi-fluid 
and nourishing. Have the sick room quiet and let 
it be darkened. 

The patient may be greatly benefited and the 
course of the disease shortened, with the prevention 
of the usual bad after effects, by thoroughly, 
gently and persistently loosening the musculature 
of the back, and especially of the back of the neck. 
See Nos. 5, 9, 11, 7B, 10, 13, 14, 47, 48, 50, 53, 57, 
61. The abdomen may be thoroughly treated. It 
will draw the blood away from the congested spine 
and spinal coverings. See Nos. 94, 95, 98. 



214 Practice of Osteopathy 

GENERAL COLDS. 

The author of this book fears a cold more than 
many of the diseases that are regarded as being 
serious. Never be afraid of breathing cold air or 
night air. Pure cold air will never cause a cold. 
Nansen, the arctic explorer, said that there were no 
colds among his officers or crew while they were 
in the Far North in the regions of ice, but when they 
returned to civilization they nearly all contracted 
severe colds. 

Those leading an out-of-door life, though exposed 
to the elements, seldom contract colds, but the 
persons who spend much time in illy-ventilated 
rooms, which are overcrowded and overheated, fre- 
quently have colds ; or when these conditions exist, 
without the overcrowding, in the houses of the rich, 
we find the inmates are very susceptible to colds. 

When we are exposed to draughts while we are 
sitting still the tissues of the upper part of the 
back and the neck become contracted. This inter- 
feres with the circulation and any latent germs read- 
ily find a lodging place. When a person is over- 
worked, either mentally or physically, or is suffer- 
ing from some chronic illness he is more predis- 
posed to a cold. 

The S3^mptoms of a common cold are varied. 
There may be pain on swallowing, loss of voice or 



Disease and Its Treatment 215 

severe hoarseness, cough and expectoration, a 
slight fever with headache and a general aching 
over the body, sneezing and running of the nose. 

In treating a cold it is best to give a general 
treatment rather briskly. Take a hot foot bath, an 
injection of warm salt water, a tablespoon of salt 
to a quart of water, a hot lemonade and go to bed. 
It will be best to remain in bed as long as the fever 
lasts. The treatment equalizes the circulation. If 
you are liable to colds it will be better to sleep in 
a cold, well-ventilated room. See that the bowels 
have a free movement once each day. Take a daily 
cold sponge bath each day. Discard furs and neck 
mufflers and wear thin underwear, keeping warm 
by the use of heavy outer garments. My objection 
to the furs is that we are liable to leave them off 
on some occasion and thus contract a severe cold. 
It would be well for those liable to colds to take a 
course of Osteopathic treatments, build up their 
constitution, and thus avoid colds. 



216 Practice of Osteopathy 

LOBAR PNEUMONIA. 

(Lung Fever, Pneumonia, Croupous Pneumonia, 
Fibrinous Pneumonia.) 

This is an acute, infectious disease which pro- 
duces an inflammation of the lungs. It usually 
begins with a chill and the fever rises rapidly to 
104 or 105. 

Some of the factors that predispose to the dis- 
ease are weakness of the lung tissue, caused by 
lesions to spine and ribs, affecting the circulation 
which nourishes the substance of the lungs, old 
age, injuries, operations, overwork, exposure, al- 
coholism, influenza, diabetes, tuberculosis and colds. 
The immediate cause is the diploccocus lanceolatus, 
a specific microorganism which is found in a very 
large percentage of the cases. 

Symptoms. On inspection we note that the 
patient has a very bright eye, dilated nostrils, pale 
face or mahogany flush on the cheek. The skin 
is harsh and dry. The respiration runs from 30 to 
60 in an adult and from 60 to 90 in a child per 
minute. The inspiration and expiration are both 
brief, yet often separated by a long pause. There 
is deficient expansion on the affected side, and a 
pain stabbing in character beneath the nipple or 
axilla. The cough is short, dry and painful. It 
sets in early and is usually attended with a rusty 
or blood-stained sputum. It may be white, glairy 
and scanty at first. 

In elderly persons this disease is peculiarly dan- 



Disease and Its Treatment 217 

gerous. The prostration is marked, but the fever is 
irregular and is not high, the cough, pain and expec- 
toration are very slight and may be altogether ab- 
sent. The disease may seem light, but with persons 
sixty years of age the mortality rate is 60 to 80 per 
cent, under the regular medical treatment, while at 
all ages Osier says that it is the most fatal of all 
acute diseases. 

Treatment. The osteopathic treatment, as out- 
lined below, is very successful in the subjection of 
this disease. If the patient is taken in hand early 
we may expect to abort the case. Kt any stage it 
gives great relief. The patient may be turned on 
the sound side and a very thorough relaxing treat- 
ment be given to all the muscles of the back, partic- 
ularly on the affected side. See Nos. 53, 57, 59, 61. 
The spine should be worked upon and sprung from 
one end to the other. See No. 57. When this is 
accomplished turn the patient on the back and treat 
the neck, both front and back, for the purpose of 
relaxing all the tissues, both deep and superficial. 
See Nos. 4, 5, 9, 18. Raise the clavicles. See No. 
70. Depress the first ribs, as in No. 76. Treat in 
the suboccipital foss^ for the purpose of reducing 
the fever. See No. 7B. Raise the ribs on both 
sides. See Nos. 86, 87. Give a thorough abdominal 
treatment. See Nos. 94, 96, 100, 101, 102. This 
helps to draw the blood away from the lungs. This 
treatment may be given in full once per day, but 
the ribs may be raised, treatment for the fever and 
some relaxing work over the chest and abdomen may 



218 Practice of Osteopathy 

be given three or four times per day. Very quick 
improvement is expected under this treatment. The 
treatment should be moderate in strength when the 
patient is weak. 

Dr. Osier says that there is no specific treatment 
for the disease, and cautions that patients are more 
often damaged than helped by the promiscuous 
drugging that is only too prevalent. 

Some medical writers recommend when the 
symptoms of pneumonia are present to give a laxa- 
tive and tonic composed of 

Calomel 5 grains. 

Quinine 10 grains. 

to be given in one dose, and to give a warm mustard 
foot bath. Should the heart be weak, good whiskey 
may be given at intervals during the day. It is both 
a food and a stimulant and if necessary from one- 
fourth to a pint may be given in one day. It mmst 
be given to those who have been drinking it prior 
to the attack of the disease. 

Cold packs are splendid in their efficacy. When 
the temperature is above 102 they should be ap- 
plied every half hour. When below that point every 
hour, and discontinued when the temperature is at 

The compress should consist of three layers, when 
applied, of old linen, cut in such a way that it will 
fit the entire chest, both front and back, from the 
neck and over the shoulders and down to the umbil- 
icus. A piece of flannel should be so cut as to cover 
the linen. The linen is wet in water at 60 degrees 



Disease and Its Treatment 2.19 

and applied and covered by the flannel and pinned 
with safety pins. There should be two compresses, 
using one after the other. 

Diet. The diet should consist largely of milk, 
soft-boiled eggs, meat juices and egg albumen. Give 
plenty of cold water, lemonade and soda water. 

BRONCHO PNEUMONIA. 

(Lobular Pneumonia, Capillary Bronchitis, 
Catarrhal Pneumonia.) 

Broncho pneumonia is an acute disease, in which 
there is an inflammation of the terminal bronchus 
and the air vessels connected with it. The condition 
is due to an infection, which is allowed by a weak- 
ened condition, which may be brought on by a num- 
ber of causes. 

There are two forms recognized. The primary 
form sets in with a chill and a cough. A child may 
have convulsions. There may have been no previous 
sickness, but there may have been a cold. Fever 
rises rapidly and ranges from 102 to 104. The skin 
is dry, hot and harsh. The cough is hard and pain- 
ful. Breathing is diflicult. Respiration may be 60 
to 80 per minute. The face may become dusky and 
the finger tips and lips blue. The expectoration is 
white, glairy, tenacious and is often tinged with 
blood. 

The secondary form follows some other illness 
and is the more common of the two. It is most fre- 
quently met with in children. The symptoms are 
usually veiled by the previous sickness. The initial 



220 Practice of Osteopathy 

chill is rare. The fever develops or increases sud- 
denly. Respiration quickly jumps to 60 to 80 per 
minute. The pulse is high. Fever is 102 to 104. 
It may last from one to eight weeks. 

Treatment. We may expect great relief and a 
speedy recovery of the case by giving the osteo- 
pathic treatment as outlined in lobar pneumonia. 
This is the best possible treatment. In the case of 
children good hygiene and careful nursing are of 
the utmost importance. Let there be plenty of 
fresh air. If possible let the child be in one room 
while the other is being thoroughly aired. Change 
the position frequently. Do not allow the patient 
to lie on the back for too long at a time, as this 
predisposes to congestion of the lungs. A warm 
bath and an enema should be given at the first 
symptoms. 

When the nose and throat are dry pour into the 
nostrils 10 to 15 drops of salt water, three or four 
times per day from a teaspoon. When the digestion 
is poor and the tongue is coated the following has 
been recommended : 

Dilute hydrochloric acid. . . .one dram. 

Essence of pepsin two ounces 

Give a teaspoonful four times per day. 

If the osteopathic treatment is properly given no 
drugs are ever necessary in any case. 

In the treatment of this disease in an adult the 
feet should have a hot mustard bath. The following 
is recommended to be given in one dose in case the 
medical treatment is followed: 



Disease and Its Treatment 221 

Calomel 5 grains 

Quinine 10 grains. 

The patient may have whiskey, as indicatec^ in 
lobar pneumonia. In case there is trouble in rais- 
ing the phlegm, raise the foot of the bed six or seven 
inches. 

DIPHTHERIA. 

Diphtheria is an acute, infectious and contagious 
disease caused by the Klebs-Loeffler bacillus, with- 
out which it is a simple membranous inflammation. 
The disease is characterized by a fibrinous exudate 
or grayish-white membrane in the throat, extend- 
ing over the tonsils and soft palate. There is ir' 
regular fever and great prostration. 

In many cases the fever may not be above 102 
or 103, while the pulse is from 100 to 120. As the 
disease advances the urine becomes highly colored 
and scanty. The mind may sometimes remain clear, 
but as the poison generated by the disease becomes 
more abundant the patient become dull and list- 
less. 

Osteopathic treatment is very successfully given 
in this disease. The tissues of the neck, both front 
and back, should be kept thoroughly loosened. See 
Nos. 4, 5, 6, 7B, 8B, 10, 11, 13. The clavicles should 
be raised. See Nos. 72, 73. 

The first ribs should be depressed. See No. 76. 
Relax the tissues back of and beneath the clavicles. 
This work should stop the growth of the membrane 
and loosen that already formed. The thumb should 



222 Practice of Osteopathy 

relax the tissues in front of the transverse processes 
of the vertebrse in the neck and the cervical sym- 
pathetic ganglia should be stimulated. See No. 7C. 
The back should be treated twice daily, paying par- 
ticular attention to the middle portions. See Nos. 
34, 36, 35, 43, 53. Keep the patient in a cool, sunny 
and well-ventilated room. 

For cleaning the nostrils and pharynx a salt solu- 
tion may be used, a teaspoonful to a pint of water. 
A little of this may be poured into the nostrils from 
a spoon every two hours. Should the nostrils be 
stopped it may be necessary to use a syringe. For 
this same purpose a mercuric bicloride solution may 
be used, in water 1 to 10,000. 

When the digestion needs aid the following pre- 
scription is sometimes given : 

Essence of pepsin 2 ounces 

Dilute hydrochloric acid . . .^ drachm. 
Give a teaspoonful three times per day. 

When a stimulant is needed one-fiftieth of a 
grain of strychnine three times per day, or give 
whiskey or Tokay wine. 

In case there is incessant vomiting, give one to 
two drops of tincture of iodine in sweetened pepper- 
mint water every two hours until the stomach is 
quiet. 

The diet is important. It should be nutritious and 
easy of digestion, custard, eggnog, cornstarch. If 
the bowels are too active give burnt flour soup. In 
addition there may be given pineapple juice, milk, 
cocoa, eggs, cream and farina. 



Disease and Its Treatment 223 



ECZEMA. 

This term is from a Greek word, meaning to boil 
over. There are a number of varieties of the dis- 
ease. Several types may be present at once or 
they may appear one after the other. There is in- 
tense itching, burning, redness and swelling of the 
parts affected. The skin is harsh, dry and thick- 
ened. The parts may become scaly. On scratch- 
ing, as the result of irritation, there is inflammation 
and crusting of the surface. There is a papular type 
in which there is a number of closely set, bright red 
papules, particularly about the joints, and the itch- 
ing is intense. The vesicular type begins with pin- 
point vesicles, very closely set together. Solid 
sheets of eruption form, the vesicles break and there 
is a raw weeping, sometimes spoken of as weeping 
eczema. 

Among the causes ascribed are rheumatism and 
gout, digestive disturbances, general debility and 
a poor nerve supply; immoderate use of food and 
drink, alcoholic beverages, tea and coffee drinking; 
exposure to heat and cold, and overwork of a men- 
tal character. 

In treating, the Osteopath has splendid success 
with this disease. The treatment is thoroughly 
given, paying considerable attention to that region 



224 Practice of Osteopathy 

of the spine from the atlas to the first lumbar ver- 
tebra. With the heel of the hand the entire fascia 
of the spine is relaxed from sacrum to occiput. See 
Figs. 48, 50 and 51. Give a general treatment. See 
general treatment. This should be given twice per 
Vi^cek and should take from twenty to thirty minutes 
to a treatment. 

The diet should be plain and nutritious. Avoid 
all meat, gravies and pastries, cheese, condiments 
and sauces. It will be better to avoid tea and coffee, 
and all alcohol must be left alone. Out of doors in 
good weather is best. The prognosis is very favor- 
able. 



Disease and Its Treatment 225 

CROUP. 

The onset of catarrhal croup is sudden. It comes 
on mostly at night. Generally it is preceded by a 
slight cough and running at the nose the preceding 
day. The cough is very characteristic, harsh, dry, 
metallic, loud and hoarse. The fright of the child 
in having difficulty in breathing adds to the severity 
of the symptoms. The lips and nails become bluish 
in color. The symptoms during the following day 
have almost disappeared or are much milder. 

Treatment. The osteopathic treatment is the 
sa-m^ as for diphtheria, which see. 

An emetic, promptly administered, will generally 
relieve the symptoms. The following is frequently 
used: 

Triturate of antimony, 1-100 of a grain. 

Ipecac, 1-100 of a grain. 

Give one every fifteen minutes until the patient 
vomits. Give one every four hours during the day. 

Coal oil, fifteen to twenty drops on sugar, given 
every fifteen or thirty minutes, sometimes proves to 
be of great value. This may be also used as an ex- 
ternal application on the chest and throat. 

Give the child plenty of fresh air and bathe the 
child's chest with cold water. 

ERYSIPELAS. 
(St. Anthony's Fire.) 

Erysipelas is an acute, contagious disease charac- 
terized by inflammation of the skin, which is red, 



226 Practice of Osteopathy 

tense and shining. Spots form, which are reddish in 
color, which coalesce and small blisters appear. 
There is a rapidly-rising temperature, often pre- 
ceded by a rigor. The constitutional symptoms are 
often marked. There may be delirium, dry tongue 
and feeble pulse. The disease is often confined to 
the face, but may wander (erysipelas migrans) to 
the neck, chest and other parts of the body. 

ISTo medical treatment has any effect on the dis- 
ease. A two per cent solution of carbolic acid in 
cold water may be used, but cold water is as good 
as any local application. The disease is caused by 
a poor circulation in the part affected, and a lowered 
vitality which allows the direct exciting cause of 
the disease (the streptococcus erysipelatosus) to 
gain a foothold. 

The quickest way to rid the patient of the disease, 
if in the face, is to relax all the tissues of the neck. 
See Nos. 1, 3, 5, 8B, 9-10, 11. Spring the lower 
jaws against resistance. See No. 8. Give a thor- 
ough spinal and abdominal treatment, to quicken 
the action of the bowels and kidneys and to aid in 
carrying off the poisons. See Nos. 31, 32, 34, 35, 43, 
48, 50, 94, 97, 100. Give a salt water enema. Fur- 
nish the patient with a good, nutritious diet. As in 
most acute cases, the patient should receive the os- 
teopathic treatment daily. 

TONSILLITIS, Acute. 

This is an inflammation of the tonsils which may 
result in a cure, suppuration (quinsy), or in chronic 
enlargement. 



Disease and Its Treatment 227 

This disease is contagious and is often a fore- 
runner of rheumatism. It affords a medium of en- 
trance for various microorganisms. It is preceded 
by a pain in the back and Hmbs, with a rapidly ris- 
ing fever. The tongue is coated and furred. Swal- 
lowing is difficult. The urine is dark. The tonsils, 
which may be felt below the angle of the jaw, are 
swollen and tender. On inspection they may seem 
to nearly close the throat. They are red, with a 
glazed surface at first, but later are covered with a 
thin layer of pus. This in some cases may assume 
a grayish hue. If it spreads over the throat and 
upwards on the roof of the mouth diphtheria may be 
suspected. See diphtheria. 

Treatment. The best possible treatment is os- 
teopathic. All the tissues of the neck are relaxed, 
both front and back. See Nos. 1, 3, 5, 8B, 9, 10, 
11, 13. The clavicles are raised and corrected. See 
Nos. 72, 73. 

The first rib is lowered. See Nos. 75, 76. Many 
cases will be helped by a general treatment, which 
see. All the above will insure a good circulation to 
the affected parts. All neck lesions are to be re- 
moved, as in this portion of the spine arises the 
nerve supply to the tonsils. In ordinary practice in 
treating tonsillitis one attack predisposees to an- 
other, but the author has treated a number of pa- 
tients osteopathically for the trouble and the disease 
did not return. Of course the lesions affecting the 
circulation were removed. Keep the bowels open. 
Salt water enema will be beneficial. Drop salt 



228 Practice of Osteopathy 

water into the nostrils every two or three hours. 
Cold compresses will prove helpful, placed on the 
throat. See cold compresses. 

QUINSY. 

(Follicular Tonsillitis.) 

The inflammation is more deeply seated than in 
acute tonsillitis. The patient is greatly prostrated. 
A high temperature of from 104 tO' 105 degrees is 
common. The tendency is for the glands to sup- 
purate. The treatment will be the same as for 
acute tonsillitis. The only difference is that hot 
fomentations will be better than the cold pack in 
the latter stages. The glands should be opened 
early. If taken early with osteopathic treatment the 
case may be aborted. 

CHRONIC TONSILLITIS. 

(Enlarged Tonsils.) 

Enlarged tonsils are found in many children fol- 
lowing tonsillitis, diphtheria or some of the eruptive 
fevers. This condition, in many cases, causes mouth 
breathing. The sense of taste, hearing and smell 
is often impaired. In cases that are very marked 
the mental faculties are impaired. Such patients 
take cold easily and are susceptible to diphtheria. 
The osteopathic treatment is the same as outlined 
in acute tonsillitis, with the exception of cold packs. 
It should be given three times per week. When the 
case is better, then twice per week for a while. In 



Disease and Its Treatment 229 

the chronic condition the tonsils may be manipu- 
lated with benefit. See No. 8B. 

In addition to the above treatment it will be well 
to use pressure with the flat of the hand on the front 
and sides of the neck for the purpose of opening- up 
and freeing all vessels to and from the tonsils. If 
these channels had been free there would have been 
no chronic trouble with the tonsils. Most Osteo- 
paths give a general treatment, giving attention 
to the excretories. 

The prognosis under Osteopathic treatment is 
very favorable. The Osteopath keeps the drainage 
of the venous blood in good condition and thus 
speedily cures the case. Of course quicker results 
are secured in acute cases than in chronic ones. 

Some persons are subject to attacks of tonsillitis 
every year, developing into quinsy. In such cases 
when I commenced treating them soon after the 
yearly attack began I found that the quinsy was 
aborted and the tonsillitis soon cured. But what 
was still better the yearly attacks ceased entirely. 



230 Practice of Osteopathy 



MEASLES. 
(Moribilli.) 

This is an acute, infectious, very contagious dis- 
ease. Before the eruption there will be a cough, cold 
in the head with running at the nose and fever. This 
will be followed by a brownish-red eruption at the 
end of the fourth day of the sickness. It appears 
first on the neck, then on the face, forehead and 
trunk. One or more papules may be seen on the 
hard palate twenty-four hours before it appears on 
the face. 

Small red spots with a minute bluish-white center 
may be seen on the inside of the lips and cheeks, 
from one to three days before the eruption is seen 
on the body. This is known as Koplik's sign. 

If the rash is slow in appearing a general spinal 
treatment should be given, paying particular atten- 
tion to the upper part of the neck. See Nos. 1, 5, 9, 
10, 36, 43, 48, 50, 53. The author has caused the 
rash to appear very quickly with one treatment, as 
indicated above. This causes the headache and 
fever to disappear. Treat the head, Nos. 14, 16 ; 
neck, Nos. 4, 6, 7B ; throat. No. 8B ; first rib and 
clavicle, Nos. 76, 75, 72, 73. Raise the ribs to guard 
against pneumonia, Nos. 81, 86, 87. Other than this 
nothing can be done to lessen the severity or short- 
en a case of measles. It is best to have the room 
darkened on account of the eyes. If the eyes are 



Disease and Its Treatment 231 

sore, keep clean with a saturated solution of boric 
acid. Cover with cloths wet with ice water. The 
food should be liquid and light. When the itching 
is troublesome anoint with plain or carbolized vase- 
line. When the rash has abated a warm bath should 
be given daily. Be careful of the eyes for several 
weeks after convalescence. 

GERMAN MEASLES. 
(Rotheln, Rubella.) 

This is a very mild, contagious disease. It spreads 
with great rapidity. There is a very mild fever and 
there is a headache, pain in the back and limbs 
and sore throat, with swelling of the cervical glands. 

The symptoms are very mild, and it is much less 
serious as a disease than measles. There is a macu- 
lar rose-red eruption on the throat, which extends 
to the face and chest and then to all parts of the 
body. Sometimes the eruption is confined to the 
upper part of the body only; again it may even in- 
vade the soles of the feet, and the palms of the 
hand. The rash reaches its height on one part of 
the body while it fades on another. Its duration 
is from two to five days or longer. When the rash 
leaves, the skin is pigmented with a brownish color, 
which disappears in a few days. It is well for the 
patient to remain in bed. The diet should be light. 
Drink plenty of water for the sake of the kidneys. 
Keep the bowels open. The tissues about the neck 
and throat should be relaxed. See Nos. 1, 5, 6, SB, 
10, 7B. The entire musculature of the back should 



232 Practice of Osteopathy 

be relaxed and a spinal treatment given. This helps 
in keeping the skin more active, which aids in bring- 
ing the disease to a speedy termination. For the 
spinal treatment see Nos. 34, 36, 43, 48 49, 52, 59, 
61. 

WHOOPING COUGH. 

(Pertussis.) 

This is a very highly contagious disease, caused 
by a specific-microorganism. It is characterized by 
a catarrhal inflammation of the respiratory pas- 
sages, with a peculiar series of spasmodic coughs, 
which end in a long-drawn inspiration, or " whoop." 
In infancy it is a very severe disease, but in child- 
hood it is mild. The nervous symptoms may be- 
come so severe as to become apparent in convul- 
sions. Broncho pneumonia is one of the frequent 
complications. 

There is no remedy in the drug line for this dis- 
ease. Holt says that much harm is done by indis- 
criminate drugging. Keep the child out of doors 
as much as possible, and keep the rooms in which 
the child lives as well aired and as fresh as possible. 
Unless this is done the disease may be unduly pro- 
longed by reinfection. The bowels should be kept 
open and keep to a liquid diet as far as possible. 

Should the case be severe the tissues in the neck, 
both front and back, should be carefully loosened. 
The first rib should be depressed and the clavicle, 
or collar bone, raised. See Nos. 1, 2, 4, 5, 6, 8B, 



Disease and Its Treatment 233 

9, 72, 73, 75, 76. The other upper ribs should be 
raised. See Nos. 86, 82. 

This stimulates the lungs and eases respiration, 
and prevents pneumonia by keeping up a good cir- 
culation. Thorough and careful manipulation of 
the tissues of the back will benefit the case. See 
Nos. 34, 43, 44, 47, 48, 50. Keep the hyoid bone free. 
See No. 6. 

TUBERCULOSIS. 

Tuberculosis is the greatest scourge and most 
widespread malady of the human race. It has aptly 
been termed a social disease, for it prevails more 
largely in the great cities and in those spots where 
humanity has been crowded together. 

According to the United States census report of 
1900 more than ten per cent of deaths were at- 
tributed to the White Plague. More than 150,000 
in our country die annually of this dread disease. 
So prevalent is the disease, that no less an authority 
than Dr. William Osier says that few persons reach 
maturity without infection and that none reach old 
age without a focus or infected area somewhere. 

When we consider that every tubercular patient, 
when the disease is active, throws off countless mil- 
lions of the germs of tuberculosis daily, that these 
germs have extraordinary vitality, and can withstand 
freezing, that they may survive months in water, 
and have great power to resist active chemical 
agents, even nitric acid, and still retain power to in- 
fect for mouths, when we further consider the care- 



234 Practice of Osteopathy 

lessness, both of the pubHc and the victims, it 
is a wonder that we are not all infected early 
in life and the earth swept clean of mankind. 
As it is one-seventh of all deaths, the world 
over, are the result of these germs. 

The parts of the body most frequently attacked 
are the lymphatic glands, the lungs, the intestinal 
tract, bones, skin, brain, joints, uterus. Fallopian 
tubes, spleen and testicles. 

CHRONIC TUBERCULOSIS. 
(Chronic Pumonary Tuberculosis.) 

The disease m^ay be latent in the system for some 
time in the form of miliary tubercles, which are 
small, gray, hard nodules ranging in size from a mus- 
tard seed to a bean. These break down and scatter 
the bacilli through the system, which sets up new 
points of infection. An injury, a severe cold or 
some acute disease may cause them to break up 
and disseminate. Some of them may lodge in 
weakened lung tissue. The infection may come from 
without and the onset, whether it be abrupt or 
gradual, will depend on the number and activity of 
the bacilli at work and the weakness of the tissues 
which they attack. 

When the onset is sudden the symptoms may re- 
semble those of lobar pneumonia^ only the fever is 
more irregular, the expectoration is more abundant 
and blood-stained and the bacilli are present. Chills 
and fever may be the first symptom noted, and in 
malarial regions mistakes in diagnosis are frequent- 



Disease and Its Treatment 235 

ly made. The first warning may come with hem- 
optysis (a bleeding from the lungs), which is bright 
red in color and is to be distinguished from blood 
from the stomach, which will be dark in color. In 
many cases much blood will be lost and frequent 
hemorrhages follow, but after the first there may be 
an absence of this symptom for years. Every case 
exhibiting this symptom should be regarded as hav- 
ing tuberculosis, and treatment should be com- 
menced and every precaution taken to ward off the 
disease. 

The disease may come on gradually with symp- 
toms of bronchitis, pleurisy, stomach and intestinal 
disorders. About one-third of all cases of pleurisy 
terminate in tuberculosis. The stomach and intes- 
tinal disturbances cause loss of weight and general 
debility, which lowers the resisting powers of the 
body. 

Cough. In a very few cases this symptom may be 
absent. In the beginning of this disease it is dry 
and hacking and is most pronounced on retiring and 
rising from bed in the morning. The cough in some 
cases becomes very distressing and weakening, and 
may be so pronounced as to cause vomiting. 

Pain. This symptom varies considerably. Pain 
in the chest may be absent, or it may be an early 
and nagging symptom. It may be sharp and stab- 
bing and more or less constant, or only present when 
coughing. 

Sputum. This varies in character as the disease 
progresses. At first it is white, glairy and scanty. 



236 Practice of Osteopathy 

Later it may be tinged with blood. As the case ad- 
vances there are larger quantities and it becomes 
more purulent, with greenish gray masses and sinks 
in water. 

Expansion. There should be a difference of not 
less than three inches in the measurement of the 
chest in inspiration and expiration. Less than this 
points to tubercular tendencies. 

Fever is often an early indication of the progress 
of the disease. The high temperature occurs about 
five o'clock in the afternoon, the low about five in the 
morning. It should be taken on rising and every 
two hours afterwards until retiring. This should be 
done for several successive days. A part of the 
time it may fall below normal. If it rises to 99.6 
F. at night for several successive evenings the diag- 
nosis of tuberculosis is strongly confirmed. 

Emaciation. On account of the fever, loss of 
appetite and cough, the loss of flesh, both fat and 
muscle, is oftentimes rapid and may be marked early 
in the disease. This symptom with the cough, ex- 
pectoration, fever and the flattening of the chest on 
the affected side, loss of expansion and dullness on 
percussion just above, over or below, the clavicle 
are the principal points of diagnosis. To be certain 
of the diagnosis in the early stages the bacilli must 
be found by microscopic examination. This can 
only be done in a well equipped laboratory. 

Treatment. Preventative measures are of the 
greatest importance. Children of families in which 
there is a taint of the disease should be taken in 



Disease and Its Treatment 237 

hand early and every effort made to build them up 
in order to resist the inroads of the bacilli. If there 
are any anatomical deviations from the normal they 
should receive osteopathic treatment. This will in- 
sure the proper nourishment to the part, or parts, 
liable to be infected. 

Particular attention should be paid to catarrhal 
troubles. Let the child be out of doors as much as 
possible. The underclothing should be woolen. 
Have the diet plain and substantial, with plenty of 
milk and fat. 

Those suffering from the disease should not be al- 
lowed to spit anywhere but in some receptacle, 
which can be thoroughly cleaned and the contents 
burned. Paper receivers have been recommended. 
The utmost cleanliness, in this respect, is necessary 
for the welfare of the patient. He should never 
swallow any of the sputa, as he is liable to start 
new foci of infection. 

The open-air treatment is of great value. This 
has been emphasized in the case of rabbits which 
have been inoculated. Those confined in cellars 
died, while those allowed tO' run out recovered. 
Fresh air and sunshine -are invaluable. The patient 
should remain out most of the day. If he has fever 
he must be quiet, but still he may be out of doors. 
Cold should not be allowed to drive him in, and 
arrangements should be made for sleeping out of 
doors. If he must stay inside let him sleep alone in 
a large, well-ventilated room. 

Osteopathic Treatment. Its value can hardly be 



238 Practice of Osteopathy 

overestimated. The nerve supply to the lungs, of 
course, governs the blood supply to the lung tis- 
sue. When the spine is rigid in the upper dorsal 
region, or v^^hen the vertebrae are misplaced, or when 
the ribs are out of proper relationship with the 
spine, or too close together, or twisted, or drooping, 
they press upon and interfere with nerves closely 
related with the vasomotor nerves of the lungs 
and pleura. When derangements occur, as 
spoken of above, other organs, as heart, stomach, 
liver, bowels, kidneys, etc., may be affected, and this 
in turn weakens the general system and has an in- 
direct effect on the lungs. We cannot be too care- 
ful of the general health. To build up the resisting 
power of the patient is of the greatest importance. 

The spine should be carefully examined, paying 
particular attention to the dorsal region. Examine 
the ribs and clavicles. The work should be directed 
to the removal of all lesions found. 

In the general treatment of this disease a thor- 
ough spinal treatment should be given for the pur- 
pose of toning up the entire system. See treatments 
Nos. 32, 34, 35, 36, 38, 43, 51, 53, 57, 47. The ribs 
should be raised, giving special attention to the first 
and second ribs. See Nos. 78, 80, 81. Raise the clavi- 
cles. See Nos. 72, 73. All tissues of the neck 
should be thoroughly relaxed. See Nos. 1, 2, 4, 5, 
6, 7, 8B, 9, 10, 11, 13. The abdomen should be 
treated as in Nos. 94, 95, 96, 98, 100. The treatment 
should be given gently and carefully at first, and 
its severity increased as the patient grows stronger 



Disease and Its Treatment 239 

and is able to stand it. About three times per week 
is sufficient in most cases, for the treatment. 

Drugs. Medical texts are almost in accord as to 
the uselessness of drug therapy. The cough is na- 
ture's effort to expel a foreign substance, but when 
it becomes irritating at night and exhausts the pa- 
tient by preventing sleep a fourth of a grain of 
morphine is frequently advised or one-tenth of a 
grain of heroin. Before resorting to drugs for this 
purpose use osteopathic measures as advised in 
Nos. 5, 6, 7, 8B, for treating the throat and hyoid 
bone. 

Deep Breathing. It will be well for the patient to 
secure all the oxygen possible. At the same time 
the muscles of the chest may be built up and its ca- 
pacity greatly enlarged. Proper breathing will help. 
To do so properly your clothing must be loose. 
Relax your muscles. Stand easily with the hands on 
the abdomen. Now take a full, deep breath slowly, 
allowing the abdomen to swell out. Then exhale 
slowly, forcing the abdomen in. The abdominal 
type of breathing brings into full play the dia- 
phraghm, which increases the capacity of the chest 
and aids in expelling the air. When you can breathe 
correctly in this manner, and it will take practice, 
you may inhale a long, deep breath, bringing the 
arms slowly from the sides until they meet over the 
head, at the same time rising on the tiptoes. Ex- 
hale slowly, bringing the arms back to the sides 
again. Do this several times per day, ten or fifteen 
minutes at a time, preferably in the open air. When 
you walk see that your breathing is correct. 



240 Practice of Osteopathy 

Diet. The diet should be nourishing and ample. 
The battle against the disease depends largely on 
the ability of the patient to digest his food. It 
should consist largely of the following: Oyster, 
clam, barley, bouillon and chicken soups. Also heavy 
soups made of peas, beans, tomatoes, celery, flavored 
with meat extracts. Rare roast beef, beefsteak, 
lamb or mutton, chicken, turkey, eggs, ham, tongue, 
oysters, herring, cereals of all kinds, butter, olive 
oil on lettuce or raw tomatoes, cream on everything 
with which it is palatable, fat bacon, potatoes, green 
peas, string beans, spinach, cauliflower, asparagus, 
onions, green salads, milk, buttermilk, honey, coffee, 
chocolate, cocoa, puddings, ice cream, etc. 

Keep the bowels open, eat five times per day, not 
too much at a time. Five drops of dilute hydrochlo- 
ric acid taken in a wineglass of water, twice per 
day, will aid digestion. 

MUMPS. 
(Parotitis.) 

This is a specific, contagious disease characterized 
by pain, swelling and inflammation of the parotid 
glands. This gland is located on the side of the 
face, immediately below and in front of the external 
ear, the lobe of which is lifted up when the swell- 
ing occurs. The pain is increased by chewing, swal- 
lowing and taking acid substances into the mouth. 
The pain often precedes the swelling. Both sides 
may be involved at the same time. It may occur 



Disease and Its Treatment 241 

in only one, or one may be several days later than 
the other. The symptoms generally last for from 
three to five days, as the disease is self-limited. 

If the pain is severe, apply warm applications. 
The hot water bottle or bag is the best. The diet 
should be liquid. The gland may be supported by 
cotton held in position by a bandage. Keep the 
bowels open and the room well aired. 

Osteopathic treatment is excellent in this disease. 
It adds to the comfort of the patient and shortens 
the malady. The spine should be thoroughly treat- 
ed, paying especial attention to the neck. See Nos. 
1, 5, 9, 34, 36, 43. Very careful, relaxing work may 
be performed over the glands. Have the patient 
open and close the mouth against resistance. See 
No. 8. 

AUTUMNAL CATARRH. 

(Hay Fever.) 

This is an affection of the upper air passages, not 
unlike a bad cold in the head, with varying symp- 
toms, often with asthmatic attacks. It occurs most- 
ly in the warm weather, generally in the late sum- 
mer. It occurs each year at about the same time, 
often to the very day. It is very abrupt in its at- 
tack. There is a copious, thin, watery discharge 
from the nose. The eyes are red, swollen and suf- 
fused. The sense of taste and smell may be im- 
paired. The appetite is poor and there is frequently 
a slight fever. The attack continues for from four 
to six weeks, or until a hard frost appears. 



242 Practice oi Osteopathy 

The first cause is an impairment of the circula- 
tion to the mucous membrane of the upper air pas- 
sag-es, and is generally caused by lesions in the neck, 
upper dorsal, clavicle and ribs, as low as the fifth, 
affecting the vaso-motor and sensory nerves and 
also the blood vessels. 

Cases of many years' standing have been cured 
by removing these real first causes. Particular at- 
tention must be paid to these lesions. All of the 
muscles of the upper part of the thorax, the spinal 
and neck muscles should be thoroughly relaxed. See 
Nos. 1, 2, 5, 7B, 9, 10, 11, 36, 34, 43, 44, 47, 48. 
The ribs and clavicles should be raised. See Nos. 
72, 73, 86. Relax all the tissues of the face and fore- 
head and about the eyes. See Nos. 14, 16, 20, 17, 
21. Exert pressure on the head, as in No. 15. Open 
the mouth against resistance. See No. 8. Treat 
along the sides of the nose. See No. 18. Give deep 
abdominal treatment. See Nos. 94, 95, 100. 

Have the patient avoid overwork. Treat three 
times per week. Treatment should be commenced a 
month or more before the attack is expected. 

ACUTE CORYZA. 
(Cold in the Head.) 

This trouble is an inflammation of the upper air 
passages, accompanied by a catarrh. It sometimes 
precedes another disease, as in measles. It is often 
epidemic and there is supposed to be a specific mi- 
croorganism as the cause. 

When the disease is frequent it leads to chronic 
catarrh. 



Disease and Its Treatment 243 

Treatment. A general osteopathic treatment 
should be given with vigor. See general treat- 
ment. Give special attention to the bowels. See 
Nos. 94, 95, 100, 97. Such a treatment will keep 
the cold from becoming serious and will abort a 
case of la grippe or pneumonia. Special attention 
should be given to the head and neck treatment. See 
Nos. 1, 5, 7, 9, 14, 7B. It will be well to take a hot 
lemonade on retiring. Some writers recommend 
snuffing from the hand every two or three hours 
some witch hazel (fluid extract of hamamelis), or 
Pond's extract. The bowels should be kept open. 

LARYNGITIS. 

This disease is an acute inflammation of the mu- 
cous membrane lining the larynx. It often appears 
with cold in the head, or may appear as a result of 
a blow or the effects of burning by hot drinks or 
poisons. Or it may be the result of the over use or 
improper use of the voice. It is very frequently due 
to lesions affecting the nerve and blood supply of 
the larynx. The above causes are then the second- 
ary causes. 

Treatment. The specific lesion must be removed 
as soon as possible. All of the tissues of the neck 
must be thoroughly relaxed. See Nos. 1, 2, 5, 9, 
10, 11, 8B, 7B. The muscles of the upper part of 
the chest and back must be manipulated for the 
purpose of restoring them to normal, that there may 
be no pressure on nerves and that the circulation 



244 Practice of Osteopathy 

may be free. See Nos. 34, 36, 43, 86. Open the 
mouth against resistance. See No. 8. Work deep- 
ly along the trachea and larynx. See Nos. 6, 8B. 

If there is an irritating cough at night some medi- 
cal authorities would give ten grains of Dover's 
powder. 

SPASMODIC LARYNGITIS. 

(Laryngismus Stridulus. False Croup.) 

This trouble is often associated with acute laryn- 
gitis in children, and has its origin in an affection of 
the nerves. The osteopathic treatment should be 
a relaxing one and should follow that for laryngitis. 
By inserting the finger into the throat and tickling 
the fauces the patient may be made to vomit, which 
Vvill prove helpful. A warm bath will assist in break- 
ing up the spasm. A cold sponge bath should be 
given daily. The treatment should be directed to 
building up the general health of the patient. See 
general osteopathic treatment. In ordinary cases 
it should be given twice per week. When the pa- 
tient is better once per week will be sufficient. 

BRONCHITIS, ACUTE. 

This disorder is a catarrhal inflammation of the 
bronchial tubes. It follows coryza (cold in the 
head), and is often a continuation of that cold by a 
continuity of tissue. It is frequently called " cold 
in the chest." 

The Osteopath looks for tightened tissues in the 
upper part of the back and neck and finds them. 



Disease and Its Treatment 245 

The tissues of the neck, both front and back, are 
thoroughly relaxed. See Nbs. 1, 5, 9, 10, 11, 8B, 
7B. The muscles and ligaments of the back are 
well loosened. See Nos. 34. 34, 36, 43, 44. Relax 
all the tissues over the chest. The ribs are to be 
raised. See Nos. 62, 86. The clavicles should be ad- 
justed, generally by raising them. See Nos. 72, 73. 
In a severe case of bronchitis, with coughing, an 
ice bag applied to the spine from the fourth dorsal 
to the first lumbar will prove helpful. A hot mus- 
tard foot bath, with a mild mustard plaster on the 
chest, will also give relief. Give hot lemonade. 
Some medical authorities would recommend a laxa- 
tive and at bedtime a ten grain Dover's powder for 
the cough. 

CHRONIC BRONCHITIS. 

The aged are afflicted with this disease when there 
has been a number of attacks of the acute form. 
The osteopathic treatment, as outlined for acute 
bronchitis, will be found very helpful. It may be 
given twice per week. 

ASTHMA. 

Asthma is a chronic affection of the bronchi, in 
which there are paroxysms of difficult breathing, sup- 
posed to be due to the muscular contraction of the 
smaller bronchial tubes. It may last for a few min- 
utes or for several hours, and often occurs nightly for 
a few days or up to two weeks. Some patients have 



246 Practice of Osteopathy 

warning symptoms peculiar to each, while in other 
cases the attack comes suddenly, without warning. 

Asthma is supposed to be a nervous affection. 
Heredity plays an important part. There are many 
exciting causes acting as irritants, such as reflex 
irritations from other parts of the body, as stomach, 
bowels, ovaries, uterus, etc. Chemical vapors, dust, 
fog, smoke, the smell of certain animals, as cat, 
horse, dog, also the pollen of plants, also colds, anger 
and fright may also excite the disease to activity. 

The real cause of the disease is to be found in 
anatomical derangement of the spine and ribs. This 
is proven by the fact that many who have had the 
disease for years and have tried everything in the 
form of treatments, without benefit, were cured 
when the anatomical maladjustments were removed. 
There will generally be found in the neck, clavicles, 
first to the sixth ribs and corresponding vertebrae 
some lesion that will account for the disease. 

When we wish to relieve the patient the spinal 
muscles are relaxed, as are the tissues of the neck. 
See Nos. 1, 5, 7B, 9, 10, 11, 13, 34, 36, 43, 44. The 
clavicles and ribs are raised. See Nos. 72, 73, 82, 
83, 88. Great relief should follow at once. When 
there is no paroxysm the treatment may be given 
once in ten days. Find and remove any vertebral 
or rib lesion present. See treatment of spine and 
ribs. See Nos. 52, 53, 57, 58, 86. Give the relaxing 
treatment as above. 

In addition to this a thorough general treatment 
may be given. 



Disease and Its Treatment 247 

Medical Relief. A few whiffs of chloroform will 
give temporary relief. The patient may inhale a 
solution of nitrite of amyl, three to four drops on 
a handkerchief. For the prevention of the disease 
fifteen grains of iodide of potassium, given three 
times per day, is recommended. Hot coffee or hot 
whiskey toddy will (sometimes) ward off an attack. 
Tobacco smoke inhaled has proven helpful. If 
the attack is caused by overeating or a disordered 
condition of the stomach or bowels or both they 
should be emptied. 

Diet. It will be well to be careful with the diet. 
The heavy meals should be taken not later than 
noon. The sweets, or any article of food that tends 
to form gas in the stomach, should be interdicted. 

CONGESTION OF THE LUNGS. 

The blood vessels of the lungs are engorged. This 
causes difficult breathing, with coughing, during 
which bloody sputum is raised. The active form 
may be caused by over-exertion or exposure to the 
extremes of heat and cold. The passive form may be 
secondary to a weak heart, or to valvular heart trou- 
ble, or to continued lying on the back. The Osteo- 
path finds lesions in the upper dorsal vertebrae 
and upper ribs. 

The treatment is directed to a stimulation of the 
nerves by a thorough treatment of the upper 
dorsal vertebrae. See Nos. 43, 50. Relaxing of all 
tissues of the chest, especially between the ribs, also 



248 Practice of Osteopathy 

the tissues of the upper part of the back. See Nos. 
1, 5, 34, 36, 37, 43. Raise the ribs. See Nos. 82, 
84, 86. The pneumogastric nerve and the superior 
cervical sympathetics should be treated. See Nos. 
7, 7C. Let there be thorough work over the abdo- 
men. Nos. 94, 96, 100. This will assist in drawing 
the blood away from the lungs to the vessels of the 
bowels. Flex and rotate the limbs. Immediate re- 
lief may be expected. 

EDEMA OF THE LUNGS. 

In this trouble there is a transudation of the serum 
from the capillaries into the air cells. The prognosis 
is not favorable. The treatment is the same as for 
congestion of the lungs. In acute cases medical 
treatment calls for a free movement of the bowels. 

EMPHYSEMA. 

This disease is an abnormal condition of the lungs, 
in which air has been retained, weakening the lung 
cells. The vesicular, or hypertropic form, of the 
disease, is when the cells and smaller tubes have 
been stretched by pressure of the air and conse- 
quently weakened. The chest is enlarged and the 
breathing is difficult. On percussion the note is 
hyperresonant. 

The disease comes on gradually. It may be well 
advanced before it is noticed. A shortness of 
breath, a slight lividity, may be noticed qn slight 



Disease and Its Treatment 249 

exertion. The chest presents a barrel shape and in 
respiration moves as if it were in one piece. The 
heart sounds are weak. 

Bronchitis and asthma are often associated with 
this disease. These are frequently the cause of the 
most distressing symptoms. The tendency is for 
the patient to grow worse as cold weather advan- 
ces. The disease also grows worse as the patient 
grows older. 

In interstitial (interlobular) emphysema the air 
escapes from the ruptured vesicles into the inter- 
lobular tissue. 

Treatment. The patient's condition may be im- 
proved under osteopathic treat ment, but not cured. 
Osier says, " No remedy is known which has any 
influence over the progress of the condition itself." 
Of course this refers to drugs. The osteopathic 
treatment will be the same as for bronchitis, with 
the addition of a stimulating treatment between the 
second and seventh dorsal to improve the heart ac- 
tion and help the circulation. See Nos. 34, 37, 43. 
It will help the patient to raise the ribs when he is 
taking a full breath and to compress the thorax as 
he expels the air. See Nos. 82, 86. Stimulate the 
vagi nerves. See No. 7. Treat three times per week. 

PLEURISY. 

There are two main forms, which may be specified 
as dry or adhesive pleurisy, and pleurisy with effu- 
sion. 



250 Practice of Osteopathy 

The disease is an inflammation of the pleura, the 
lining of the lung. In the dry pleurisy a friction 
murmur may be heard. There is a slight fever and 
pain in the side over the point of inflammation. 

In pleurisy with effusion there is frequently a 
chill, followed by a fever which rises to 102 to 103 
and remains for a week or for several weeks. The 
pain is very sharp and may be referred to the nipple, 
or to the axilla, or to the back, or to the abdomen. 
There is difficult breathing and the pain is aggra- 
vated on coughing. 

Treatment consists in the removal of all vertebral 
and rib lesions. Clavicle and rib lesions are often 
the actual cause of the disease. All of the spinal and 
intercostal muscles should be relaxed. See Nos. 34, 
36, 40, 43, 44, 53. The tissues of the neck should 
be thoroughly treated. See Nos. 1, 5, 7B, 6, 8B. 
Ribs and clavicles should be raised. See Nos. 72, 
73, 82, 84, 86, 88. A thorough spinal treatmeni 
should be given, with special attention to the tenth 
eleventh and twelfth dorsal vertebrae. See Nos. 49, 
50, 57, 48, 51, 52. Give a treatment over the bowels. 
See Nos. 94, 96, 100. The treatment may be given 
daily for a while. 

The chronic case may be treated for about three 
times per week. Hot water bottles or bags should 
be applied over the seat of the pain. Some cases 
are benefited by wearing a moist compress, wrung 
out of cold water and changed every two hours. 

Under medical treatment the patient who has 
pleurisy with effusion is given saline purges in th^ 



Disease and Its Treatment 251 

nope of reducing the fluid. This failing the patient 
is tapped. 

PNEUMOTHORAX. HYDROPNEUMOTHOR- 
AX. PYOPNEUMOTHORAX. HYDRO- 
THORAX. HEMOTHORAX. 

In all of the above conditions in which there is 
air or gas, water and gas, pus and gas, water or 
blood in the pleural cavity the osteopathic treatment 
will be the same, which is the same practically as for 
pleurisy. 

The relaxation of muscular tissues, both front and 
back of the chest. See Nos. 34, 36, 40, 43, 44, 53. 
Raise all the ribs and clavicles. See Nos. 72, 82, 84, 
86, 88. Give a thorough spinal treatment. See Nos. 
48, 49, 50, 51, 52, 57. All of this work will give more 
room for the lungs and make the breathing much 
easier. 

In many of these cases there is some disease acting 
as a primary cause. It may be of the lungs, kidneys, 
liver, blood or heart, or it may be the result of some 
accident. In such cases the primary disease needs 
treatment in connection with the active symptoms 
caused by it. 

These cases are very serious and may need the 
assistance of the surgeon. 

RICKETS. 

This is an infantile disease, in which the body is 
poorly nourished and changes appear in the growing 



252 Practice of Osteopathy 

bones, which tend to deformity. The disease comes 
on slowly about the time of teething. Restlessness 
at night, sweating of the head, constipation and 
beading of the ribs are early symptoms. The beads 
spoken of are at the junction of the costal cartilages 
and the ribs. If the child has walked he does not 
want to walk now. The body is sore and he does 
not wish to be moved. There may be a slight fever. 
The skin is pale, the tissues are soft and flabby. The 
sternum projects, causing the child to become chick- 
en-breasted. 

The head is larger than it should be, owing to a 
thickening of the bones. The face looks small, the 
forehead is broad and square. In some cases there 
is a deformity of the bones of the arms and legs, and 
in some cases there is not a bone in the body that 
escapes. Some children grow thin, some fat, but in 
the latter case the flesh is soft and flabby. 

Osteopathic treatment will stop the deformity and 
give better nutrition. The treatment is general in 
its scope, with special attention paid to reducing the 
deformities and removing spinal and rib lesions. See 
general treatment. 

Some medical writers recommend one-one hun- 
dred and twentieth of a grain of phosphorus dis- 
solved in olive oil, given twice per day. Cod liver 
oil in teaspoonful doses is also recommended. 

Diet. Do not allow candy, sugar, etc., but give 
eggs, milk, cream and good meat. 

The child should be in the open air as much as 
possible and have a warm bath about three times 
per week. 



Disease and Its Treatment 253 

OBESITY. 

(Corpulence.) 

Obesity is an excessive amount of fat, that not 
only becomes an inconvenience but seriously im- 
pairs the health by infiltrating and weakening the 
heart muscles, also the lungs, liver and kidneys. 

The controlling factors may be heredity, bad 
habits of eating and drinking, lack of exercise, and 
spinal lesions which interfere with the proper work 
of the liver, pancreas and lymphatic system. 

This condition must not be overcome too sudden- 
ly. The lesions may be removed as soon as possible. 
The clavicles are to be raised and the first rib 
lowered. See Nos. 72, 73, 75, 76. A thorough spinal 
treatment must be given for the stimulation of the 
liver, pancreas and kidneys. See Nos. 2)2, 43, 57. 
Vigorous treatment over the fat tends to its absorp- 
tion. Give a general treatment, which see. 

Diet. The diet must be restricted. Starches, fats 
and sweets are to be eliminated as much as possible. 
The use of water is to be restricted and alcoholic 
drinks are to be prohibited. 

Regular exercise must be taken. If the heart is 
weak begin moderately and gradually increase the 
exercise. Walking is very beneficial. 

Some medical authorities give from three to five 
grains of the dry, powdered thyroid gland, three 
times per day. It must be discontinued when it 
causes any heart disturbance. It should not be tak- 
en if there is any heart trouble. 



254 Practice of Osteopathy 

My experience in treating obesity along Osteo- 
pathic lines has been very satisfactory. One lady 
about twenty-four years of age, who was a teacher, 
weighing over two hundred pounds, had a valvular 
heart lesion and I concluded that her weight ought 
to be reduced. 

The patient was put on a diet as follows: For 
breakfast and supper, one soft-boiled egg and one 
piece of toast, and for dinner the same, with the 
addition of some green vegetable which grew above 
the ground. This diet was adhered to with Osteo- 
pathic treatments three times per week for two 
months. In this time the patient lost fifty-two 
pounds. Her appetite was too large before she be- 
gan to diet, and she had considerable trouble in 
adhering to the menu. As the odor of cooking food 
made her ravenous, she left the house while meals 
were being prepared. At about the end of two 
months she asked if she could have all the hot bis- 
cuits and honey she wanted. The request was 
granted, the food prepared, and her capacity was 
one half a biscuit. 

She ate what she desired afterward. Her appe- 
tite was more moderate and she still holds her light 
weight, though she is married and has one child. 
She was treated four years ago. 

Another case was that of a lady about thirty. 
She weighed something over three hundred. She 
had apparent good health and was quite muscular. 
This patient was put on a restricted diet by simply 
telling her to eat much less. The Osteopathic treat- 



Disease and Its Treatment 255 

ment was given about three months. The patient 
lost some during the treatment, but lost more after 
the treatment. In six months her loss in weight 
was sixty pounds, which made a great change, for 
the better, in her personal appearance. In both of 
the above cases the good results were secured by 
improving the lymphatic circulation. This is done 
by raising the clavicles and lowering the first rib 
and paying considerable attention to the spinal 
treatment in the upper dorsal region. In addition 
to this a general treatment was given. In giving 
Osteopathic treatment for different troubles you will 
find that if the treatment is adapted to each case in 
a proper manner, it tends to restore the patient to 
the normal in weight as well as restore the health. 
A thin person would take on flesh and a heavy one 
would be reduced. 



256 Practice of Osteopathy 



DIABETES INSIPIDUS. 

This is a chronic condition, in which large quan- 
tities of urine are passed daily of low specific grav- 
ity, and without sugar or albumen. While the dis- 
ease occurs most frequently among the young, there 
has been no definite cause given by medical writ- 
ers. It is often accompanied by nervousness and 
may be caused by an injury to the spinal cord or 
brain. 

As in diabetes mellitus, the disease may come on 
suddenly as a result of fright or injury, but gener- 
ally it is gradual in its appearance. There is great 
thirst and the patient drinks great quantities of 
water. The skin is dry and harsh and the appetite is 
good, and the general health does not seem to be im- 
paired. It is incurable from the medical standpoint, 
but cases have been greatly benefited and many have 
been cured under osteopathic treatment. 

Lesions are found in the middle of the back, from 
which the kidneys are enervated. The neck also 
furnishes some lesions where the medulla would be 
affected through nerves in that region. The treat- 
ment should be a thorough general one, as in neuras- 
thenia, paying especial attention to the lesions in 
the middle of the back and in the neck. See Nos. 
34, 36, 37, 43, 48, 51, 52, 1, 4, 5, 7B, 9, 11, 13. See 
general treatment. 



Disease and Its Treatment 257 

DIABETES MELLITUS. 

This a constitutional disease, characterized by a 
copious amount of urine, in which there is a large 
percentage of sugar. A disordered nutrition allows 
the sugar to accumulate in the blood, from which it 
is eliminated by the kidneys. It is not a disease of 
the kidneys. 

It is claimed that in some cases it is hereditary. 
Males and Jews and the better classes are afflicted 
with the disease more frequently than others. The 
real cause is unknown from the medical standpoint. 
It often follows worry, mental shock, and severe 
nervous strains and diseases or injury to the spinal 
cord. Some writers believe the disease to be conta- 
gious. Osteopaths find lesions in the middle and 
lower part of the back with occasional neck lesions. 

Symptoms. An unusual thirst and the passing of 
urine frequently are generally the first symptoms 
noted. The onset of the disease is gradual, but may 
be sudden, following fright, shock, etc. The tongue 
is dry, red and glazed. The gums are tender and 
bleed easily. The appetite is enormous. Patient 
grows progressively weak and thin. Skin is dry 
and harsh. The urine may amount to two or three 
quarts or as high as four or five gallons daily. 

Boils, carbuncles, eczema and gangrene, associated 
with arteriosclerosis, constipation, enlarged liver 
and profuse sweating are some of the complications 
of the disease. 

Treatment, The osteopathic treatment is most 



258 Practice of Osteopathy 

vdluMc. It should be general and thorough, suited 
to the strength and requirements of the patient. See 
general treatment. The lesions are generally in the 
lower and middle part of the back and sometimes m 
the ribs, over the liver. Spinal lesions must be re- 
moved. See Nos. 34, 36, 43, 51, 52, 57, 58, 98. 

Diet. The diet is of the utmost importance. All 
starches and sugars in all forms should be elimi- 
nated. Avoid everything made of flour, as much as 
possible, such as cake, pie, pastry, pudding, maca- 
roni, also rice, tapioca, oatmeal, corn meal, hominy. 

Avoid potatoes, peas, beans, turnips, cauliflower. 
The patient must not eat oysters, clams or liver. 
Avoid sweet fruits, chestnuts and peanuts, beer and 
sour wine. 

Good Things to Eat. 

Clear soups made of any kind of meat. Eggs in 
all styles. Fresh fish. Fresh meats of all kinds ex- 
cept livers. Fats of all kinds. Vegetables such as 
lettuce, tomatoes, spinach, cress, radishes, asparagus, 
cucumbers and celery. 

Fruits. All acid fruits. 

Drinks. Lemonade, tea, coffee, chocolate, cocoa. 
The above may be sweetened with saccharin, but no 
sugar. Buttermilk and sour milk may be used. 

Bread. Gluten and bran bread and breads made 
of aleuronat and reborat flours are to be recom- 
mended. 

In families predisposed to the disease, starches 



Disease and Its Treatment 259 

and sugars should be interdicted. The patient 
should avoid worry and colds. Luke-warm or cold 
baths may be taken daily. 

RHEUMATIC FEVER. 
(Acute Articular Rheumatism.) 

This is an acute, noncontagious fever, most like- 
ly caused by a germ, and manifesting itself by an 
attack on one or more joints. In the joint afflicted 
there will be heat, pain, redness and swelling, the 
nbrous tissue being inflamed. 

The disease sets in quickly, though it may be pre- 
ceded by slight, irregular pains in the joints, sore 
throat and tonsillitis. The fever rises to 102 to 
105, the pulse is generally above 100 and one or 
more joints become very painful. The urine is high- 
ly colored, scanty and acid. There is a very profuse, 
acid, sour-smelling sweat, which has a very char- 
acteristic odor. The tenderness, redness and swell- 
ing subside in one joint as the pain begins in an- 
other. There is prostration, loss of appetite and 
considerable thirst. 

The most serious complications of this fever are 
the heart affections, endocarditis, pericarditis and 
myocarditis, inflammations of the inner and outer 
lining and heart muscle, respectively. Osier quotes 
several writers who say that it is a self-limited dis- 
ease and that medicine has no influence on its du- 
ration or course. 

Treatment. Osteopathic treatment performs won- 



260 Practice of Osteopathy 

ders in cases of rheumatism. The treatment begins 
at the nerve supply of the joint affected, which is in 
the lower part of the spine in case the joints of 
the lower limbs are affected, and in the neck and up- 
per dorsal region in case the joints of the arms axe 
attacked. In case the knee joint was the part that 
suffered the most, the treatment would begin in 
the lower dorsal region and lumbar region of the 
spine, thoroughly loosening the muscles and work- 
ing there as in Nos. 61, 48, if possible. Then work 
gradually down the limb, as in Nos. 113, 116. When 
you reach the knee it will be generally ready for a 
firm, careful, relaxing treatment. Loosen all the 
tissues about it and end this part of the treatment 
by grasping the calf of the leg and the tissues below 
the knee with both hands and giving the leg a care- 
ful pull, thus stretching the joint and allowing a 
better circulation. After this is completed a general 
treatment will be in order, giving attention to the 
middle of the back, in the lower dorsal and lumbar 
regions. See general treatment. Raise the ribs. 
See Nos. 86, 87. Give a stimulating treatment in 
the upper dorsal region for the purpose of stimulat- 
ing the heart. This treatment, given in connection 
with the compresses, spoken of below, will be found 
to be satisfactory and no drugs will be needed. 

On account of the profuse sweating, flannel night- 
gowns should be worn and blankets used instead of 
sheets. The diet usually used in fevers is best, be- 
ing sure that the foods are light and nutritious. 



Disease and Its Treatment 261 

Lemonade and oatmeal water may be very freely 
used. 

Cold compresses are used with a great deal of sat- 
isfaction in Germany. Old linen or worn-out cotton 
sheeting should be so folded that when applied there 
will be only three or four thicknesses of the material. 
This, wet in very cold water, placed snugly on the 
joint and covered closely with flannel. To avoid 
changing too frequently the flannel may be removed 
and cold water allowed to drip on the bandage, after 
which the flannel is replaced. 

Another treatment is the hot fomentation. Prep- 
aration is made for this by securing two pieces of 
old woolen blanket, fifteen to eighteen inches square. 
One of these is to be used at a time and is to be 
saturated in boiling water. That it may be wrung 
out well, so that but little water will remain, take 
a strong crash roller towel. Fasten two strong 
sticks at either end of the towel and place the blan- 
ket between the layers of towel. Immerse in boiling 
water and remove, wringing as dry as possible by 
twisting on the sticks. Place the blanket on the 
joint and cover with another piece of blanket. The 
part to receive the hot application should be anoint- 
ed with olive oil or vaseline. The compress should 
be renewed every fifteen minutes for an hour, when 
the part should be carefully dried and wrapped in 
cotton batting or woolen. 

Another treatment : If the pain in any joint is 
severe, hot cloths wrung out of the following solu- 
tion may be applied: 



262 Practice of Osteopathy 

Carbonate of soda 6 drachms. 

Laudanum 1 ounce. 

Glycerine 2 ounces. 

Water 9 ounces. 

Chloroform liniment is also recommended as an 
external application. 

The medical internal treatment is very unsatis- 
factory. The best for the pain and for general relief 
is salicin, twenty grains of which may be taken every 
hour and a half until the pain is reduced. Another 
treatment is twenty grains of salicylic acid, given 
every two hours in a capsule until the pain is re- 
lieved. Still another is twenty grains of salicylate 
of soda, every two hours until the pain is reduced, 
and then every five hours after until the tempera- 
ture begins to be reduced. Still another, in case any 
of the above are tried and fails to agree, is twenty 
minims of oil of wintergreen given every two hours 
in milk. 

ARTHRITIS DEFORMANS. 
(Rheumatic Gout, Rheumatoid Arthritis.) 

Rheumatic arthritis is a chronic disease of the 
joints. The disease is believed to originate in the 
spine. The fact that after making an attack on any 
particular joint of one hand it will next attack the 
corresponding joint of the other hand, indicates that 
the disease is of central origin, which is referred back 
to the spine. 

Another theory is that the disease is caused by a 



Disease and Its Treatment 263 

specific microorganism and is the result of this in- 
fection. 

The bone in the joint enlarges. The cartilages and 
the muscles waste. The skin becomes pigmented 
and glossy, which intensifies the appearance of the 
deformity. In most cases there is intense pain, while 
in others the disease may progress and the deformi- 
ties increase with little or no pain. In the early 
stages the disease often resembles acute articular 
rheumatism, but the disease persisting in joints first 
attacked is an important point in the diagnosis. 

The disease is rarely curable, but is not dangerous 
to life. 

Treatment. Any lesion found in the spine should 
be removed. The articulation should be kept pliable, 
and the joints affected should be stretched to facili- 
tate circulation. When the joints are inflamed, cold 
compresses should be applied. When taken off the 
parts should be thoroughly massaged. This tends 
to reduce the swelling and builds up the wasted 
cartilages and muscles. In addition to the above 
a general treatment should be given to build up the 
system. See general treatment. The patient should 
have a generous diet, as much as can properly be 
digested of wholesome, nutritious food, such as 
roast beef, beefsteak, mutton, chicken, eggs, milk, 
cod liver oil, olive oil, butter, cream, etc. Alcoholic 
beverages in small amounts may be taken with the 
meals for their tonic effect, and malt liquors are al- 
lowable. Of course alcohol in any form is not ad- 
missible in cases of rheumatism, as it tends to ag- 



264: Practice of Osteopathy 

gravate the disorder. In the disease under consider- 
ation, alcoholic or malt liquors should not be al- 
lowed when there is fever or much pain in the joints. 

GOUT. 

(Podagra.) 

Gout is a nutritional, constitutional disease, ac- 
companied by attacks of inflammation of the joints. 
Most generally only the joints attacked are those of 
the great toe, but the joints of the ankle, knee, hands 
and wrist may be attacked as well. 

The disease is often hereditary, generally on the 
male side. Alcohol, rich food and lack of exercise 
are predisposing causes, though poor food and bad 
hygiene, with an excess of malt liquors, may cause 
what is known as " poor man's gout." If a person is 
susceptible to the disease it may be brought on by 
worry, fright, mental shock, or surgical operation. 

The attack usually comes on at night or early in 
the morning. There is insomnia, fever and rest- 
lessness. The joint is swollen, tender, and exceed- 
ingly painful. The urine is scanty and high colored, 
Constipation is a varying symptom and dyspepsia is 
often present. 

The Treatment. The spine should receive a treat- 
ment, especial attention being paid to the lower and 
lumbar region. The kidneys should be stimulated. 
See Nos. 34, 43. A general treatment should be 
given in many cases. See general treatment. If the 
great toe is painful begin the treatment in the lower 



Disease and Its Treatment 265 

part of the back and work slowly, carefully, and 
thoroughly down the limb to the toe. See Nos. 113, 
116, 117, 118, 119. Move all the tissues to the bone 
to assist circulation. The joint may be gently ma- 
nipulated from side to side and carefully stretched. 
This, if carefully done, will eliminate the pain and 
assist the circulation to carry away the deposit in 
the joint. The part in which the pain is present 
should be carefully protected from the cold and kept 
elevated. Those who are susceptible to this disease 
should be very careful with the diet, and should 
abstain from alcohol in all its forms. An outdoor 
life, with plenty of exercise, is best. Keep the skin 
active by frequent bathing. If the patient is strong, 
have him use cold baths in the morning, followed by 
a vigorous friction with a coarse towel. If the pa- 
tient is weak, warm baths should be taken on retir- 
ing at night. Straining efforts, both mental and 
physical, must be avoided. 

Flannels should be worn next to the skin at all 
times. A glass or two of water, taken on retiring 
and the same on rising, helps to rid the system of 
waste material. Plenty of water should be taken 
during the day. The great value of the various 
mineral waters is the water and not the substance 
it contains. If one will drink the same amount of 
water at home the benefit will be the same. Of 
course the change in environment is often desirable. 

The diet should be restricted, as overeating and 
drinking and the indulgence in meat, rich food and 
liquors, predispose to the disease. Let the living 



266 Practice of Osteopathy 

be plain. Meat once per day, with vegetables pre- 
ponderating, will be best. String beans, salads, 
cabbage, spinach, peas, fresh green vegetables, 
fruits, except bananas ; tomatoes, strawberries, far- 
inaceous foods, as rice, hominy, sago, tapioca, 
cracked wheat, butter, milk and stale bread, are 
all good and indicated for use for one subject to 
gout. 

Avoid highly seasoned foods, pastry and sweets. 

When there is fever use milk, farinaceous foods 
and plenty of water. Peppermint water may be 
given. 

MOUTH, DISEASES OF. 

The mouth should be kept clean. Left to itself 
it is the foulest cavity in the body. A dirty mouth is 
a prolific cause of disease, by harboring germs that 
cause constitutional diseases. We should do this 
when well, but should be doubly sure to keep the 
mouth absolutely clean when sick. Take good care 
of the teeth, and do not kiss on the mouth, nor allow 
children to be kissed there. 

Stomatitis Acute, resulting from local irritation or 
intestinal disturbances, may affect the gums or the 
entire surface of the tongue or mouth. At first there 
is heat, redness and dryness, followed by active 
secretion and swelling. There is often pain in mas- 
tication. 

Cleanse the mouth frequently with a two percent 
boric acid solution. 



Disease and Its Treatment 267 

Stomatitis Aphthous is a more severe form than 
the above. Vesicles appear and there is consider- 
able pain. The following washes will prove effi- 
cient : 

Alum one teaspoonful. 

Water one-half pint. 

Or the following: 

Tannic acid one drachm. 

Glycerine one ounce. 

Use thirty drops of this to a wineglass of water. 

Geographical Tongue (eczema of the tongue), 
circular patches of the superficial skin of the tongue 
become loosened and fall off. As it heals in the 
center the sore grows and enlarges about the healed 
part. The patches sometimes look like a map, hence 
the name. The cause of the disease is unknown, 
but in the case of adults it proves very obstinate. 
The following mouth wash may be used : 

Boric acid six parts. 

Salicylic acid one part. 

Water 500 parts. 

A weak solution of nitrate of silver will relieve 
the burning. 

PHARYNGITIS. 
(Sore Throat.) 

This is an acute catarrhal condition of the phar- 
ynx. The condition generally follows exposure and 
cold. It may be also due to the constant use of the 
voice, to excessive smoking, the use of certain 



268 Practice of Osteopathy 

drugs. It may be caused by a valvular disease of the 
heart or by an anurism or tumor. 

There is dryness of the throat, at first, with pain 
on swallowing, followed by a profuse secretion and 
a yellowish discharge. 

The best treatment is to thoroughly relax all the 
tissues of the neck, both front and back. See Nos. 
1, 2, 5, 6, 7B, 8B, 9, 11, 13. Depress the first ribs 
and raise the clavicles. See Nos. 75, 77, 72, 73. 
Give a spinal treatment. See Nos. 34, 43, 48, 53, 57. 
Work over the abdomen. See Nos. 94, 96, 100. 
This serves to draw the blood aAvay from the con- 
gested parts and keeps the bowels active. An 
enema, using a tablespoon of salt to a quart of water, 
will be beneficial. Use a hot foot bath and apply a 
cold compress to the throat. See cold compress. 

In severe cases the medical treatment would in- 
dicate a calomel purge, followed by salts and a 
swabbing of the throat with a solution of nitrate 
of silver, 40 grains to the ounce. 

PHARYNGITIS, CHRONIC. 

This follows repeated acute attacks. Avoid ex- 
posure. Clergymen should learn to use their voices 
better. Smokers should cease smoking and drinkers 
should not use intoxicants. The general health 
should be built up. The osteopathic treatment as 
outlined in acute pharyngitis, should be given three 
times per week, then twice, and then once per week 
as the patient grows better. 



Disease and Its Treatment 269 



SCURVY. 

This disease resembles purpura, and is due mainly 
to the use of improper food, causing chronic pto- 
maine poisoning from intestinal putrefaction. 
Tainted animal food and an infection of the mouth 
with microorganisms, associated with privation, are 
causes. Indirect causes are poor air and water, 
damp, unfavorable and overcrowded quarters and 
lack of sunlight, previous disease, cold moisture and 
persistent heat. Many authorities claim that a con- 
tinuous use of exclusive salt meat diet is a cause, 
but that lack of vegetables is not a first cause, as 
was formerly supposed. 

Diagnosis. The gums are swollen and pulpy. 
There are lesions of the bones, muscles, skin, gums 
and viscera, which indicate a change in the compo- 
sition and properties of the blood. The disease 
comes on slowly. There is shortness of breath and 
flitting pains in the back and legs. The skin is 
sallow, resembling the cachexia of cancer. There 
is physical and mental weakness. The skin soon 
grows dry and rough and is marked by small purple 
spots, mostly on the legs. Patches, looking like 
bruises, are soon seen, and soft, tender swellings 
appear on the legs. The eyelids are sometimes 
swollen and purple and the conjunctiva red. The 
urine is scanty and there is constipation. 



270 Practice of Osteopathy 

The treatment indicated is a general Osteopathic 
one. See general treatment. Pay particular atten- 
tion to the entire spine. Treat three times per 
week. Massage gently over the swellings. 

The diet should be varied and plentiful. Fresh 
potatoes, cabbage, carrots, onions, lettuce and in 
fact all green vegetables. Oranges and lemons 
should be used plentifully; soup, beef tea, milk and 
eggs. The meat should be fresh. 



Disease and Its Treatment 271 



VOMITING. 

In many cases of acute and chronic diseases we 
frequently are called upon to combat nausea and 
vomiting. When the patient remains quietly in 
bed allow him to sip ice water at intervals. Or he 
may have a little iced tea, either peppermint or 
black. In case the vomiting is obstinate, medical 
writers recommend one-drop doses of tincture of 
iodine in sweetened peppermint water every hour 
until the condition is overcome. When the tongue 
is heavily coated and the stomach is foul it will be 
well to give a pint of warm water. This will cause 
vomiting and the tendency will be to clean out the 
stomach. 

In cases of nervous or paroxysmal vomiting the 
writer has had splendid success by applying an ice 
bag to the dorsal region from the fourth to the 
eighth vertebra. In many cases there is a peris- 
taltic action of that organ, during which it is very 
active in secreting, and the application of the ice 
bag tends to inhibit the nerves controlling this 
function. Some time ago I was called to treat a 
patient who had been suffering a half day with per- 
sistent vomiting, which was growing worse. Our 
usual method would be to inhibit the spine, which is 
a tedious operation and not always satisfactory. 



272 Practice of Osteopathy 

I applied an ice bag, as above, and the patient soon 
became quiet and slept all night. Soon after I 
had an engagement in another town to treat a pa- 
tient who had suffered an apoplectic stroke. When 
I arrived I found the patient had been vomiting 
about two hours. The usual means had failed to 
stop the trouble, as there were two doctors in at- 
tendiance. Another stroke was feared, but the ap- 
plication of ice bags to the spine and head quieted 
the patient at once and there was no further vomit- 
ing and no cerebral hemorrhage. Since that time 
I have placed great reliance in the ice 'bag for vom- 
iting when caused by nervousness. 



Disease and Its Treatment 273 

GASTRITIS. 
(Acute Gastric Catarrh. Acute Dyspepsia.) 

Some forms of stomach trouble seem to be heredi- 
tary. Many are caused by a predisposing weakness 
found in the spine, which affects the nerve supply 
to this important organ. Many cases of severe 
stomach disease are brought on through errors in 
diet, too much or too rich food, or tainted food, or 
the inordinate use of alcohol in some form, or the 
use of ice cold water at meal time. 

Symptoms. There is headache, nausea, pain in 
the stomach and abdomen, belching of gas and 
vomiting. The tongue is heavily furred. There is 
pain in the back between the shoulders, and the 
tissues here will be found to be abnormally tight. 
Sometimes there is diarrhoea. Often there is consti- 
pation. The abdomen is distended. The vomit con- 
tains food, mucus and bile. 

Treatmient, Osteopathic. See chronic gastritis. 

Medical treatment. For a child, a dose of caster 
oil; for an adult, five to eight grains of calomel, 
followed in a few hours by a dose of salts. After 
this give the stomach a rest. Soda water and ice 
may be given. See chronic gastritis. Repeated at- 
tacks of this will lead to the chronic condition. 



274 Practice of Osteopathy 

CHRONIC GASTRITIS. 

(Chronic Catarrh of the Stomach. Chronic Dyspep- 
sia.) 

This is a diseased condition of the stomach in 
which the digestion of the stomach is impaired. 
There is an increase in the formation of mucus and 
changes in the digestive fluids. The muscular coats 
of the stomach are weakened, lessening its activity. 

Symptoms. They vary greatly and change as the 
disease progresses. Pain, nausea, distress and feel- 
ing of oppression after eating are early symptoms. 
There is a constant feeling that something is wrong, 
and the patient is apt to be discouraged. He is 
melancholy, and loses ambition and dislikes exertion 
of any kind. There is considerable gas at times, 
and percussion over the stomach elicits a peculiar, 
hollow sound. The stomach may become so dis- 
tended with gas as to cause palpitation of the heart. 
There is a bad taste in the mouth and the tongue is 
coated. There may be vertigo, " heartburn," and a 
stomach cough. The urine is dark red and there 
is a deposit on standing. 

Causes. An interference with the nerve and blood 
supply, which weakens the stomach. This inter- 
ference may be in the neck, in the back from the 
fourth to the eighth dorsal vertebra, or a displace- 
ment of the corresponding ribs, or the ribs over the 
stomach. The trouble may be also caused by errors 
of diet or the long-continued use of alcohol. 



Disease and Its Treatment 275 

Treatment. Osteopathic treatment, with the prop- 
er diet, has cured countless cases after nearly every 
other treatment had been tried. Lesions of the neck 
must be corrected. Stimulate the vagus nerve which 
helps to supply the stomach with nerve force. See 
Nos. 1, 5, 3, 7, 7B. Also see Nos. 9, 10, 11, 13. Rib 
lesions must be carefully looked after and the spine 
treated between the fourth and the eighth dorsal. 
See Nos. 34, 43, 35, 53. Stimulate the solar plexus. 
See No. 100. 

Should any ribs cause mechanical pressure over 
the stomach they should be corrected. See No. 93. 
A vigorous, brisk treatment may be given over the 
stomach and abdomen. See Nos. 94, 99, 100, 101, 
102. This treatment cures permanently because it 
removes the underlying causes, other than errors 
in diet. 

Medical treatment in many cases aims to supply 
the digestant lacking. The one most frequently 
needed is hydrochloric acid. Its use is indicated 
when gas is belched and the taste is sour. To supply 
this need from 15 to 30 drops of dilute hydrochloric 
acid is taken in sugar water about fifteen minutes 
after each meal. Ten grains of pepsin may be taken 
at the same time. Rochelle salts or Carlsbad salts 
or sodium phosphate may be taken in a tumblerful 
of hot water in the morning thirty minutes before 
eating. This cleanses the stomach and prevents con- 
stipation. The bowels should move freely at least 
once per day. It is difficult to help the stomach 
much while constipation persists. 



276 Practice of Osteopathy 

Dietetic. This phase of the treatment is most 
important. The patient should be free from care 
and worry and should spend as much time out of 
doors as possible, and take plenty of time for meals, 
masticating the food well and carefully. Never 
eat when tired and rest, when possible, both before 
and after eating. A daily sponge bath in cold water, 
followed by active friction with a rough towel, will 
be helpful. 

In ordinary cases the following foods may be 
allowed : Wheat bread, stale or toasted very dry, 
soda crackers, zwieback, dry or toasted, thin slices 
of bacon broiled, butter; thick soups, thoroughly 
cooked, made of asparagus, tomatoes or fresh peas or 
potatoes ; eggs, but not hard boiled or fried ; oysters, 
fresh fish, boiled or broiled. Meats should be young 
and tender. They may consist of broiled steaks and 
chops, roast beef, mutton and chicken. Oranges, 
peaches and grape fruit are good, and it is well 
to eat them and other fresh fruit between meals. 
Prunes and apples may be baked or stewed. Black 
coffee may be taken after dinner. 

Foods Absolutely Forbidden. Fresh soft bread, 
hot bread, cakes, pastry, doughnuts, sweets, candies 
and sugar ; fat or greasy food ; heavy vegetables, 
dried, salt or corned meats or fish, veal, cheese, 
sweet fruits, hash or twice-cooked meats. 

In very severe cases, where there is Bright's dis- 
ease or heart trouble, it may become necessary to 
give an exclusive milk diet. From two to four 
quarts of fresh milk may be given in twenty-four 



Disease and Its Treatment 277 

hours. It may be given seven or eight times per 
day. If it is not well borne or the patient has an 
annoying thirst, it may be diluted with equal parts 
of soda water or Vichy or Apollinaris water. If 
the milk is taken without this a little bicarbonate 
of soda (common baking soda) may be added and 
a pinch of salt. 

Good fresh buttermilk may be used with good 
effect. If the patient can not take as much milk as 
indicated above, or enough to support strength, 
scraped meat is allowable; oysters, raw or broiled. 
Some can eat soft cooked eggs and calves' brains. 

URTICARIA. 
(Hives, Nettle Rash.) 

This trouble appears suddenly on any part of the 
body. There are small reddish or pink spots which 
cause a pricking, stinging, itching sensation. The 
spots may occur in spirals or rings, or they may be 
combined with papules. 

This trouble is generally attributed to errors of 
digestion and nervous disorders. With some in- 
dividuals strawberries or shellfish cause the hives 
to appear. 

A general treatment may be given, paying es- 
pecial attention to the stomach. See treatment for 
gastritis. Avoid foods that are known to disagree 
in this manner. The itching may be allayed with 
the use of carbolized vaseline. 



278 Practice of Osteopathy 



HEMORRHOIDS. 
(Piles.) 

Hemorrhoids, or piles, are varicose vessels, 
caused by an engorgement of the venous hemor- 
rhoidal plexus, forming tumors at or near the anus. 
They are internal or external, bleeding or dry. The 
internal are generally bleeding and the external dry. 

The symptoms vary with the size, number and 
seat of the tumors. There is a sensation of a for- 
eign body being in the rectum. There is a throb- 
bing, aching or burning pain, during and after a 
hard stool. As the tumor grows, sitting is uncom- 
fortable. Many reflex symptoms accompany piles, 
as irritable bladder, urethra and vagina. 

Any trouble that interferes with the return cir- 
culation from the rectum, as impacted faeces, con- 
stipation, a heavy or backward misplaced uterus, 
a pelvic tumor or a poor nerve supply to the plexus 
of veins affected acts as a cause. There must be 
proper tone in the muscular walls of these vessels for 
the blood properly to circulate. In diseases of the 
liver, lungs and heart we find piles in many cases. 

In treating this condition we must remove the 
underlying cause as soon as possible. If it is a 
simple case of piles, without complications, we often 
find trouble in the articulation of the coccyx and 



Disease and Its Treatment 279 

sacrum, or in iliac-sacral synchondrosis. I have se- 
cured excellent results, in some cases, by a stimu- 
lating treatment over the sacrum. The patient lying 
on the table, in a prone position, v^ork over the 
sacrum with the flat of the hand as indicated in Fig. 
48. This loosens up all the structures there and 
stimulates the nerves. The coccyx is frequently 
found misplaced. The patient lying across the 
table, on his breast, and his feet on the floor pre- 
sents a fine position for manipulating a coccyx. 
With two thumbs it may be pushed forward, or 
from side to side as indicated. It may also be 
placed in position as in paragraph 71. The sacrum 
may be treated as in paragraphs 68 and 69. 

Do not allow the patient to become constipated, 
but regulate the diet so as to secure free daily evacu- 
ations of the bowels. Violent exercise should be 
avoided, such as long walks and heavy lifting. Do 
not sit on damp or warm seats. Do not use highly- 
seasoned food, and leave alcohol alone. 



280 Practice of Osteopathy 

APPENDICITIS. 

This disease is an inflammation of the vermiform 
appendix. It is thought by many, at the present 
time, to be a very common and serious malady. 

Cause. It may be caused by a fall or blow, result- 
ing in a spinal or rib lesion which interferes with 
the blood and nerve supply of this little organ, 
thereby producing a weakened condition. Da Costa, 
in his surgery gives the reason for men having the 
disease more frequently than women, is that women 
have a better blood supply to the appendix than 
men, a small twig being given off by the ovarian 
artery, thereby making it stronger in women than 
in men. 

Of course, when the organ is weakened and it 
is not performing its function in furnishing a secre- 
tion, which is bacteriacidal, and which assists in 
keeping the illeo-coecal valve in order, fecal matter, 
foreign bodies, such as seeds, etc., may force them- 
selves into it and help to set up inflammation. On 
this account many textbooks give erroneous causes 
for the disease, such as impactions, seeds, poison of 
rheumatic fever, la grippe, structural defects and 
"trictures and heredity. 

Symptoms. The pain is the first and most com- 
mon symptom. It comes on suddenly, and may be 
either sharp and intense or may be characterized 
as a dull ache. The pain is located in the lower 
right side of the abdomen. Pressure of the thumb 
applied at a point half way between the anterior 



Disease and Its Treatment 281 

superior point of the ilium and the umbilicus on 
the right side will cause intense pain. 

The muscles in the lower right side of the ab- 
domen are tense and contracted. The patient has 
a desire to lie on the back, and the limbs, especially 
the right one, is drawn up. 

Even in the mildest forms of appendicitis there 
is always fever in the early stages of the disease. 
The temperature ranges from 101 to 103.5. Stomach 
and intestinal disturbances are present. The tongue 
presents a furred, whitish appearance and is moist. 
There is nausea and vomiting in most cases. Con- 
stipation is the rule but diarrhoea may be present. 

Operations are often performed for appendicitis 
and the appendix is found to be entirely normal. 
One writer in a prominent medical journal recently 
said that he witnessed thirty-four operations for 
this disease, but did not see one diseased appendix. 
Doubtless many lives have been lost by over-zealous 
surgeons through hasty operations when the case 
was not properly diagnosed. There are so many 
troubles that simulate the symptoms of appendicitis 
that partially excuse some of these errors. The 
following are mistaken for appendicitis: Abscess 
of the liver, intestinal obstruction, renal colic, twists 
of the ureter, colic of intestines, peritonitis, tubercu- 
lar or otherwise, gallstone colic, coxitis, acute rheu- 
matism of the rectus abdominis muscle, inflammation 
of the Fallopian tube or ovary, herpes zoster of the 
twelfth intercostal nerve, and typhoid fever. 

The treatment of this disease calls for the removal 



282 Practice of Osteopathy 

of the causative lesion as soon as possible. In severe 
cases we must wait for the acute symptoms to sub- 
side before attempting to remove the real cause, yet 
in many cases this may be done at once. The oste- 
opathic treatment for the removal of the lesion in- 
creases the nerve and blood supply to the appendix 
at once, and assists in lowering the inflammation. 
It may be commenced by a stimulating treatment to 
the spine, while the patient is lying on the back, 
by reaching under the back and manipulating the 
spine in the upper lumbar and lower dorsal region. 
See No. 61. If possible use 34, 43, 57, after which 
careful manipulative work may be attempted over 
the abdomen for the relaxation of all the tissues 
and the improvement of the circulation. See Nos. 
94, 96, 98, 99, 100. This must be very carefully per- 
formed, but will give great relief to the patient. 
The two lower ribs should be slightly manipulated 
and raised. See Nos. 90, 91, 92. Between treatments 
an ice bag or hot fomentations should be applied 
to the seat of the inflammation. 

Constipation should be removed as soon as pos- 
sible, and it will be well to give an enema to re- 
lieve the bowels of foreign matter and permit of a 
more free circulation. In many cases the contents 
of the appendix may be removed by manipulation. 
Should the pain be too severe inhibit from the eighth 
dorsal vertebra to the first lumbar. 

After the recovery of the patient the treatment 
should be persisted in for some time, as changes 
have taken place which only a good circulation can 



Disease and Its Treatment 283 

restore. This should be done to prevent a recur- 
rence of an attack. If constipation has been a dis- 
turbing factor this must be treated and a diet 
ordered. See diet for constipation. 

INTESTINAL OBSTRUCTION. 

(Strangulation, Volvulus, Intussusception, Stric- 
ture, Tumors.) 

Strangulation by bands from adhesions is a com- 
mon form. Volvulus, a twisting of the bowel, is 
common in the sigmoid flexure. Intussusception., 
the invagination of a portion of bowel into the 
lumen of an adjacent part. The latter causes most 
cases of obstruction of the bowels in ciiildren. Stric- 
ture of the bowels may be caused by tissue of new 
formation of the nature of scar tissue or by cancer. 
Tumors outside the bowels, or fecal mass-es inside 
of the bowel may be responsible for obstruction. 

In acute ot)struction the pain comes on suddenly, 
first severe and then decreasing in severity, but 
the pain remains for some time. Cpnstipation soon' 
becomes evident, and is so absolute that even gas 
does not pass the rectum. The abdom-en becomes 
filled with gas, is very much distended and exceed- 
ingly tender on pr-essure or on movements- made by 
the patient. There is vomiting, some fever with a 
rapid pulse. 

In cases of chronic obstruction there are oc- 
casional spells of vomiting and constipation. The 
stomach is uneasy and there is a tendency to vomit. 



284 Practice of Osteopathy 

There are occasional spells of diarrhoea. The attacks 
have a tendency to recur at frequent intervals. 

Many of these forms of obstruction may be over- 
come vi^ithout the use of the knife, which is often 
considered necessary. Some cases require careful 
and persistent v^ork over the abdomen. The work 
must be directed to remove the cause after the symp- 
toms are overcome to a certain extent. Adhesive 
bands may be carefully broken up. Twists when 
located may be corrected. They are often caused 
by enteroptosis. This condition is often met with 
on the left side in the sigmoid flexure and on the 
right side in the caecum. Both may be lifted up 
and straightened. See Nos. 96, 97, 98, 99. In cases 
of intussusception the invaginated portion may be 
pulled out. 

In cases where there are fecal masses, these may 
be gradually broken up and passed along the bowel. 
Some writers recommend that the patient be placed 
on his knees, with the head and shoulders down, 
the knee-chest position, and a large injection given. 
Some authors recommend that the patient be placed 
in various positions and shaken. 

It may be necessary to give frequent enemas and 
to continue the work with the patient for some time, 
until the bowels are made to move. 

In case the pain is very severe we may inhibit the 
spine from the eighth dorsal to the first lumbar ver- 
tebra. See No. 67. 

When the patient has become better the real 
first cause must be treated, which we will find in 



Disease and Its Treatment 285 

spine or rib lesions, disturbing the nerve and blood 
supply to the bowels. A section or segment of the 
cord may have some pressure, and affects the nerves 
in such a manner that one portion of the intestine 
is too active and the adjacent portion is partially 
paralyzed, thus accounting for the intussusception 
or volvulus. For a complete cure this condition 
must be corrected. We must stay with the acute 
cases until they are better, and the chronic cases 
may be treated twice or three times per week. A 
general treatment may be indicated in the chronic 
cases. See general treatment. 

JAUNDICE. 
(Icterus.) 

This is a condition in which the bile pigments 
color the skin, mucous membranes and some fluids 
of the body. 

Lesions of the spine and ribs, which interfere with 
the nerve supply of the liver and surrounding tis- 
sues, are a frequent cause of the trouble. The direct 
cause will be found in some obstruction, it may be 
of the liver itself, which interferes with the free flow 
of the bile into the intestines. Parasites, gallstones, 
strictures or tumors may be among the causes. 

Symptoms. In catarrhal jaundice the color will 
be lighter, perhaps a lemon color. In obstructive 
jaundice the color will be much darker, may be dark 
green or bronzed. In some cases the skin is of a 
leathery, greenish-black hue. This latter condition 



286 Practice of Osteopathy 

is sometimes called black jaundice. The secretions 
of the body are colored with bile pigments. The 
sweat may color the underclothing. The color is 
apparent in the urine. The first place where the 
yellow hue is noted is in the white of the eye. 

Itching may be intense in various parts of the 
body. In some cases it precedes the attacks of the 
disease; in other cases it appears when the dis- 
ease is very much prolonged. As the bile fails to 
pass into the intestines, where it assists in the di- 
gestion of the food, the stools are whitish or grayish 
in color. 

Treatment. The condition calls for a thorough 
general osteopathic treatment. Special attention 
must be given to the liver. See treatment for 
cirrhosis of the liver. See also general treatment. 
The bile duct may be worked over and some pres- 
sure brought to bear on the gall bladder under the 
points of the ninth and tenth ribs, pressing inward 
and upward. Rib lesions, if any, must be removed. 
See Nos. 81 to 93. The spine must be manipulated 
from the fourth dorsal vertebra to the lumbar re- 
gion. See Nos. 34, 43, 48, 51, 53. Keep the liver 
active. 

Diet. It is well to avoid starches, fats, and sweets. 
Eliminate fried foods as much as possible. The ap- 
petite must be tempted. Give lemonade, the juice 
of pineapples, and oranges. Stewed fruits, soft 
cooked eggs and cereals are excellent. Drink plenty 
of water. 

The medical treatment would be calomel, five to 



Disease and Its Treatment 287 

eight grains, taken in fractional doses, followed by a 
dose of salts. Sodium phosphatee is given as in the 
treatment for gallstones, which see. To control the 
itching, use talcum powder or powdered starch, or 
sponge with a warm solution of warm baking soda. 

GALLSTONES. 

(Cholelithaisis.) 

This affection is very widespread, occurring 
chiefly in women. It is claimed that they have three- 
fourths of all the cases. It has further been authori- 
tatively stated that twenty-five per cent of all wom- 
en over sixty years of age are afflicted with the dis- 
ease. 

The stones form chiefly in the gall bladder, though 
they sometimes start in the liver. Anything that 
interferes with the free flow of the bile may be pro- 
ductive of the stones. The Osteopath finds lesions 
in the back, from between the shoulder blades to the 
eleventh dorsal vertebra. The ribs in the same re- 
gion are often out of proper relationship, either with 
the spine or with themselves. These spinal and rib 
lesions interfere with the nerve and blood supply 
of the liver. The peristaltic action of the gall blad- 
der is also interfered with by the same lesions. 
Tight lacing, the dropping down of the intestines or 
a kidney, constipation, lack of exercise, the inordi- 
nate use of rich food, or too much of any one kind 
of food, continual bending over and sedentary oc- 
cupations all predispose to this disease. 



288 Practice of Osteopathy 

When the stones are forming there are no symp- 
toms, but when the stone begins to pass through the 
duct, on its way to the intestines, intense pain de- 
velops suddenly in the upper right side of the abdo- 
men, radiating towards the umbilicus and over the 
abdomen, and under the right shoulder blade. The 
patient vomits, sweats and is in great agony. The 
temperature rises to 102 to 104. There is tenderness 
in the region of the liver and the gall bladder is 
swollen. The gall bladder lies under the thin edge 
of the liver at about the point between the ends of 
the ninth and tenth ribs. The attack lasts until the 
stone reaches the intestine. 

Treatment. All lesions found in the spine and 
ribs require immediate removal, as far as possible. 
Give a stimulative treatment in the middle of the 
spine. See Nos. 43, 44, 48, 57. The bowels may be 
manipulated carefully, and when the pain is most 
severe the spine may be held, as in No. 67. Hold 
firmly for inhibition at the eighth, ninth and tenth 
dorsal vertebrae. At the same time an attempt may 
be made to assist the stone through the duct. Re- 
member that it runs from the gall bladder in the 
shape of a reverse letter " S " to a point about one- 
half an inch below the umbilicus ! When the pa- 
tient is better, treatment should be given each day 
for awhile, paying particular attention to constipa- 
tion. The writer has successfully treated by the 
above method when surgeons said that an immedi- 
ate operation was necessary. 

The medical treatment would be about one-fourth 



Disease and Its Treatment 289 

of a grain of morphine, administered hypodermical- 
ly, assisted by a little chloroform, if the pain is very 
severe, which the patient breathes until the mor- 
phine has taken effect. Of course the morphine is 
to be given only when there is great pain. Fur- 
ther treatment would call for from two to five grains 
of calomel, followed by a dose of salts. This should 
be repeated when there are evidences of constipa- 
tion. The bowels should move at least once per day. 
A teaspoonful of the saturated solution of sodium 
phosphate should be taken in a wineglass of water 
every three hours. After the patient becomes bet- 
ter it will be well to take the sodium phosphate for 
some time at least once per day. 

When the disease is troublesome an enema of cold 
water should be used each day. Plenty of water 
should be drunk at all times. The use of hot fomen- 
tations over the liver and gall bladder will assist in 
relieving pain and will promote circulation in the 
affected point. 

Diet. Starches, fats and sugars should be avoided 
as much as possible forever after an attack. Avoid 
peas, carrots, sweet vegetables and sweet fruit; 
also egg yolks. 

Fresh green vegetables and acid fruits are highly 
recommended. Meat may be eaten once per day. 
Cereals should be well cooked. 



290 Practice of Osteopathy 

INFLAMMATION OF THE GALL DUCT 
AND BLADDER. 

The symptoms may be much the same as in gall- 
stones and it requires the same treatment. 

CIRRHOSIS OF THE LIVER. 

There are many forms of this disease, in which 
there is an increase of the connective tissue of the 
liver and a destruction of the secreting cells. 

Atropic cirrhosis of the liver is also known as hob- 
nailed liver, granular liver, and chronic interstitial 
hepatitis. It occurs in middle-aged persons. The 
liver is much reduced in size. The disease may be 
caused by alcohol, syphilis and some of the poisons 
of infectious diseases. 

Symptoms. There is progressive loss of strength. 
The patient falls off in weight, and there are dis- 
turbances of the stomach and bowels. There is 
constipation, difficult breathing, and insomnia. The 
obstruction of the portal circulation may cause 
dropsy and piles. The stools will be found to be 
clay colored. The abdominal veins around the navel 
are enlarged and form what is called the " Caput 
Medusae." There is no jaundice. The outlook is 
not very favorable,. 

Hypertrophic Cirrhosis. In this disease the liver 
is enlarged. The disease occurs chiefly in young 
people. There is jaundice. It may be very marked. 
There is no dropsy. There is pain in the region of 



Disease and Its Treatment 291 

the liver, with nausea and vomiting. The liver may 
be felt in the upper abdomen on the right side. 
Normally it comes down to the edge of the ribs. 

Treatment. We may expect the best possible re- 
sults from osteopathic treatment. There are cases, 
though, that resist all treatment. The liver may be 
stimulated by treatment in the middle and upper 
part of the back, say from the sixth dorsal to the 
first lumbar. See Nos. 34, 43, 44, 48, 49, 52, 53. 
This work will assist in regaining vaso motor con- 
trol. All lesions found must be removed. The liver 
may be worked over, as in Nos. 101, 102. Also work 
under the lower ribs carefully, as in Nos. 93, 94, 103. 
This work is to be done, of course, on the right side. 

A deep, careful abdominal treatment should be 
given. See Nos. 95 to 100. This is for the purpose 
of freeing up the circulation of the portal vein. The 
ribs on the right side must be raised if depressed. 
Correct them if luxated in any manner. See No. 
93, also Nos. 101, 102. The diet should be food eas- 
ily digested. Alcoholic drinks should be prohibited, 
as well as tea, coffee, spices, and all condiments 
which tend to excite the intestinal tract. Never al- 
low the patient to overeat, and never eat too much 
of any particular diet. Cabbage, beans, pork and 
pastry are forbidden. Some difficult cases call for 
an exclusive milk diet, which may be diluted with 
vichy if the patient is unable to take it straight. 
Drink plenty of water, vichy, ginger ale and pepper- 
mint tea. Regular hours should be kept as regards 



292 Practice of Osteopathy 

sleeping. The patient should take regular exercises. 
In many cases walking in the open air is good. 

The patient should bathe regularly and keep the 
skin active. In addition to the full tub bath, taken 
once or twice per week, the patient should take a 
cold sponge bath every morning with a brisk rub. 
Under medical treatment the bowels are to be kept 
open with Epsom salts. 

FATTY LIVER. 

(Fatty Infiltration of the Liver. Fatty Degenera- 
tion of the Liver.) 

This disease is treated practically the same as for 
cirrhosis of the liver, which see. 

PERIHEPATITIS, ACUTE AND CHRONIC. 

Treatment is the same as for cirrhosis of the liver, 
which see. 

CONGESTION OF THE LIVER. 
(Hyperaemia of the Liver.) 

When digestion is under way the liver is con- 
gested. A lazy man who is a hearty eater has a 
congested liver constantly. It may be caused from 
over indulgence in eating and drinking, or it may 
be occasioned by the various infectious fevers. 

In active congestion of the liver there is constipa- 
tion or diarrhoea, scanty, high-colored urine, a loath- 



Disease and Its Treatment 293 

ing of food, nausea, vomiting, fever, with headache 
and coated tongue. 

The osteopathic treatment should be very suc- 
cessful. The spine should be thoroughly treated. 
See Nos. 34, 43, 36, 47, 48, 50, 53, 57, 58. Remove 
all spinal and rib lesions. Raise the ribs. See Nos. 
82, 86. Work over the liver as in Nos. 93, 101, 102. 
Give a thorough abdominal treatment. See Nos. 
94, 95, 96, 97, 98, 99, 100. It will be well to give an 
enema, a tablespoon of salt to a quart of water. 
Drink plenty of water at various times during the 
day. Use sour lemonade. A liquid diet is to be pre- 
ferred. Let up on the eating. 

The medical treatment would be a half grain of 
calomel every hour for six hours, followed later by 
a dose of salts. Rest in bed with diet and drink as 
above. 

PASSIVE CONGESTION OF THE LIVER. 

This may be caused by diseases of the lungs or 
pleura, pressure on the vena cava, and from valvular 
heart disease. The treatment for this condition, of 
course, must vary with the cause of the disease. 
Most cases of congestion are to be treated as above, 
with treatment of the underlying cause. 

PERITONITIS. 

Is an inflammation of the peritoneum, a serous 
membrane lining the abdominal cavity, and enclo! ^ 
ing the contained viscera. 



294 Practice of Osteopathy 

The disease may be acute or chronic. It may be 
caused by a blow or strain, or infection following 
obstruction, or typhoid fever, or tuberculosis, or 
gonorrhoea. 

When the disease is acute there is distension of 
the abdomen, with tenderness and great pain. There 
is constipation and vomiting. The temperature 
ranges from 102 to 104. The pulse is hard and is 
from 110 to 140, and the patient breathes 25 to 40 
times per minute. 

The treatment calls for relaxation of all the spinal 
tissues, with inhibition in the lower dorsal and up- 
per lumbar region. See Nos. 47, 48, 50, 52, 53, 67. 
Give a careful abdominal treatment. See Nos. 94 
to 103, 67. The inhibition checks peristalsis of the 
bowels and the relaxation of tissues assists circula- 
tion. This work may all be done with the patient 
lying on the back. This treatment should be given 
two or three times per day. A liquid diet should 
be given, cracked ice for the thirst and give an enema 
for constipation. The ice bag or hot fomentations 
are used over the bowels. Medical treatment calls 
for the use of morphine to control the pain. 

Inflammation of the bowels, hysterical peritonitis, 
obstruction of the bowels of any kind, the rupture 
of the superior mesenteric artery, or a tubal or other 
extra uterine pregnancy may simulate peritonitis. 



Disease and Its Treatment 295 

CHOLERA. 

Cholera Nostras. Sporadic Cholera. Acute Gas- 
troenteritis.) 

This is an acute condition, characterized by vom- 
iting, purging and abdominal pains. It is frequent- 
ly accompanied by muscular pains and cramps. 

This disease is frequently met with in the sum- 
mer, and follows sudden changes in the temperature 
of thirty to forty degrees and over. It is caused by 
exposure to wet and cold, and the eating of unripe 
or overripe fruit; also vegetables of the same kind 
and canned goods and ice cream, etc. 

It begins suddenly. There may be a temperature 
of from 101 to 105 degrees. As the case progresses 
the pulse becomes weak and the extremities cool. 

Treatment. Rest in bed. Thoroughly relax all 
the spinal tissues. See Nos. 34, 43, 47, 48, 53, 57. 
Spring the spine gently from the upper dorsal to 
the lumbar region. See Nos. 57, 61. The spine 
should then be inhibited by holding it strongly just 
above the lumbar region as in No. 67, or a book 
may be placed under this same region as in No. 67, 
Fig. 66. This treatment will stop the peristalsis 
of the bowels, and thus stop the drain on the sys- 
tem. This inhibition should not be given until we 
are sure that all irritating substances have been ex- 
pelled from the bowels. 

Most medical writers recommend an evacuation 
of the bowels, either with a dose of castor oil, about 
one ounce for an adult, or a dose of Epsom salts. 



296 Practice of Osteopathy 

The diet should be bland and mild. Burnt flour 
soup, tea and toast, peppermint tea, some boiled 
rice. 

For the intense thirst give cracked ice, very weak, 
cold tea, without sugar, and not much water, be- 
cause it tends to further loosen the bowels. In a 
very severe case food may be withheld for twenty- 
four hours and a slow return made to solid food, 
among which should be well-boiled rice, soft-boiled 
eggs, milk toast and crackers. 

CHOLERA INFANTUM. 

This is a disease with symptoms much the same 
as cholera morbus, only in many cases more pro- 
nounced. When occurring in children two years or 
younger it is called cholera infantum. It is often 
due to poisons generated in the milk or other food, 
which profoundly affects the nerve centers. 

The stomach and intestines should be emptied 
as soon as possible. This is quickly effected by irri- 
gation. The temperature when high should be reg- 
ulated by baths, and if below normal, hot water 
bags should be applied to the body. The bath for 
reducing fever should last for from ten to twenty 
minutes. It should be given often. An ice cap may 
be applied to the head. 

After the stomach is cleansed nothing should be 
taken but a little ice and brandy. The regular diet 
should be restored only gradually after the symp- 
toms have subsided. 



Disease and Its Treatment 297 

The pain and colic may be relieved by strong in- 
hibition above the small of the back. See No. 67 
The child may be lifted well off the bed by clasping 
the hands beneath the back where we desire to in- 
hibit. This will give the desired pressure. Hold 
for a minute or two. All of the tissues of the back 
should be thoroughly relaxed. See Nos. 48, 57, 58, 
34, 43. Relax the tissues of the neck. See Nos. 1, 5, 
9, 10, 11. Pressure above the sacrum will stop 
cramps in the legs. An ice bag applied there and to 
the lower lumbar region will do the same. 

DYSENTERY. 
(Bloody Flux.) 

This is an acute or chronic disease of the colon, 
or large intestine. It may lead to ulceration. There 
are mucous and bloody stools. There is griping 
pain in the bowels, and a bearing down sensation, 
with an almost constant desire to go to stool. There 
may be a low fever and vomiting at the beginning of 
the trouble. 

The disease may be brought on by polluted drink- 
ing water, indigestible food, sudden changes of 
weather or unsanitary conditions. 

Treatment. The patient should rest in bed. A 
thorough relaxing spinal treatment should be given. 
See Nos. 47, 48, 57, 58, 43. Deep inhibitive treat- 
ment should be given over the abdomen. See Nos. 
94 to 100. Pressure should be exerted on the spine 
(inhibitive) from the middle dorsal to the lower lum- 



298 Practice of Osteopathy 

bar. See No. 67. One prominent medical writer 
recommends the giving of one drachm of Glauber's 
salts (sodium sulphate), from four to eight times 
per day, until blood disappears from the stools, usu- 
ally for two or three days. Light poultices, or tur- 
pentine stupes or fomentations, will be especially 
soothing to the patient. 

The diet should be restricted to milk, broth, beef 
juice and Qgg albumen. 

DIARRHOEA. 

It is always well to determine the cause of the dis- 
ease. With this trouble there may be several causes, 
one or more of which may be present. They may be 
enumerated as follows : (1) Indigestible, overripe 
or green fruit. (2) Sudden changes in the weather 
temperature. (3) Poisons generated in the food, 
as in milk, ice cream, etc., or minerals which may 
have been taken as drugs. (4) Nervous symptoms 
resulting from the emotions as fright. (5) Various 
diseases as cholera, typhoid fever, tuberculosis, etc. 
(6) Predisposing causes as anatomical derange- 
ments of the spine. 

Treatment. If the disease arises from either of the 
first three of the above causes a dose of castor oil, 
followed by an enema, is indicated, followed by a 
relaxation of all of the tissues of the spine and back. 
See Nos. 34, 36, 43, 48, 57, 58. If the condition 
arises from nervousness, rest is indicated and a thor- 
ough general treatment for the underlying causes 



Disease and Its Treatment 299 

should be given three times per week for two or 
three months. See general treatment. 

A boiled-milk diet and egg albumen may be re- 
sorted to until the troublesome symptoms have 
abated. 

When there are anatomical misplacements they 
should be removed. There are such causes in 
every chronic case, and hundreds of such cases have 
been permanently cured by the removal of suc^ 
lesions. As a paliative measure to relieve when the 
peristalsis of the bowels are persistent see No. 67. 

CONSTIPATION. 

This is a very common trouble with all ages and 
both sexes. It poisons the system, and by undue 
pressure of the fecal mass against soft tissues, is a 
prolific cause of many other diseases. Retention and 
hardness of feces, irregularity and insufficiency of 
bowel evacuation, are regarded as constipation. 

This trouble may be caused by any one or any 
combination of the following: Lesions of the spine 
or ribs, affecting the blood or nerve supply of the 
bowels, poor peristaltic action, mechanical obstruc- 
tion, impairment of quality or absence of bile, a 
flabby or pendulous condition of the abdominal 
walls and muscles, inattention to the calls of nature, 
dependence upon purgatives, improper diet, lack of 
exercise. 

Treatment. The most important thing to do is 
to remove the real cause of the torpidity of the 



300 Practice of Osteopathy 

bowels. The lower half of the spine will be gener- 
ally found at fault. A common condition is a ten- 
sion of the ligaments binding the vertebrae together, 
with a posterior condition of the lower dorsal and 
lumbar vertebrae. This affects the nerve supply to 
the bowels. This may be overcome by a thorough 
loosening up of these tightened conditions by manip- 
ulation, as in Nos. 43, 44, 48, 49, 51, 63. The entire 
muscular structures of the lower part of the back 
must be relaxed. See Nos. 64, 47, 53, 58. The low- 
er ribs if down must be raised. See Nos. 90, 91, 92. 
The bowels should be thoroughly manipulated. See 
Nos. 94 to 100. Fecal obstructions may thus be 
loosened and passed along the intestinal tract. 
Some writers recommend rolling a cannon ball, 
wrapped in some suitable covering, over the intes- 
tines for five or ten minutes each morning and even- 
ing. All spinal lesions, of whatever nature, should 
be removed. See examination of the spine. 

In a very elderly person, or where the abdominal 
walls are flabby and pendulous, a suitable abdominal 
belt should be worn until the tissues can be toned 
up by the osteopathic treatment. This will hold 
the contents from sagging and obstructing the gen- 
eral circulation of the pelvis. 

Every one should have a regular time to go to 
stool, and those liable to suffer from constipation 
should let nothing interfere with this important 
duty. Many cases of fecal retention start from neg- 
lecting the calls of nature. When suffering from 
constipation go whether you feel the necessity or 



Disease and Its Treatment 301 

not, and when you go do not be in a hurry, but ex- 
pect a movement. Do not strain. It is very injur- 
ious for a woman to do so, and in either sex may 
cause piles. 

Stop the use of purgatives, however simple and 
harmless they may be said to be. In using purga- 
tives the doses must be increased, the drug must be 
changed for another, until it is almost impossible to 
secure an action. Nature grows dependent upon 
these and their use only confirms the condition and 
makes the cure all the more difficult. 

Should the bowels prove a little obstinate to the 
above treatment, at first, use an enema, in which 
a tablespoonful of salt is used to a quart of water. 
Use a fountain syringe. Retain the water a half 
hour if you can, meanwhile massaging the bowel 
contents. This should not be done but every other 
day, and must not be continued long. Continued 
use of such a treatment weakens the tissues and 
stops the proper secretions. 

Diet. The diet should receive special attention. 
Most people are accustomed to a too concentrated 
diet, in which there is too little to pass through the 
intestines to help excite the peristaltic action by 
friction on the nerve terminals. All of the following 
foods are splendid for constipation. A diet may be 
selected from them, and in case anything is known 
not to agree with the patient it may be omitted from 
the list: Tomatoes, lettuce, spinach, asparagus, 
beans, peas, corn, potatoes, cabbage, celery, boiled 



tj2 Practice of Osteopathy 

Spanish onions, carrots, turnips, squash, pumpkin, 
and cauliflower. 

Corn and Indian meal, oatmeal, shredded wheat, 
coarse graham bread, graham gems, bran bread and 
t)ran biscuits. The bran may be mixed with gra- 
ham or white flour. The bran may also be eaten 
raw, as much as three or four tablespoons per day. 
Olive oil may be eaten on salads, lettuce and toma- 
toes. Use plenty of butter. All fruits with small 
seeds are excellent, such as figs, raspberries, black- 
berries, strawberries, grapes and huckleberries. 

Grapefruit, cherries, prunes, oranges, pears, 
peaches and apples are all splendid. Some of the 
above may be stewed if the raw fruit disagrees. 

English walnuts, butternuts, walnuts and al- 
monds. Water, coffee, cider, grapejuice, buttermilk 
and sour milk are all desirable. 

Foods to Avoid. 

Fried foods, rich sauces and gravies, sweets, 
pastry, pickles, cheese, starchy puddings, tea, sour 
wine, red wine, eggs, milk, or any other highly con- 
centrated foods. 

Two glasses of water should be taken on rising 
in the morning. Drink plenty of water between 
meals and a glass or two on retiring. Water taken 
on an empty stomach is absorbed by that organ and 
goes through the portal circulation to the liver, 
where it performs a healthful work. If plain water 
disagrees, flavor it with lemon juice or a little spice. 



Disease andi Its Treatment 303 

^ A daily cold bath, followed by a vigorous rub un- 
til the skin is made to glow, is a useful adjunct. 

If the patient follows a sedentary life, and is in- 
doors much of the time, exercise is to be recom- 
mended, such as walking, horseback riding, tennis 
playing, bowling, etc. 

ENURESIS. 
Incontinence of Urine. Bed Wetting. 

This trouble is a nervous condition, which inter- 
feres with the normal nerve impulses in the lumbar 
region of the spinal cord and produces an involun- 
tary discharge of urine. The lesions found are in 
the lower dorsal, lumbar and sacral regions. Their 
removal leads to a permanent cure. Frequently the 
lumbar portion of the spine is stifif and straight. 
Treat about twice per week. See Nos. 51, 52, 57, 
58. 

While the patient is in the knee-chest position 
the ischia may be gently separated as in Fig. 108. 
The abdominal contents may be lifted up, as de- 
scribed in paragraph 96, taking care to begin as low 
down as the pubis, so the bladder and uterus may 
be elevated some. The sacroiliac synchondrosis 
should be slightly loosened, as indicated in para- 
graphs 106 and 107. 

This treatment, properly given, will effect a cure. 
If the patient is nervous give a general treatment in 
addition. See general treatment. 

The patient for a time should eat the largest meal 



304 Practice of Osteopathy 

at noon. Drink plenty of water early in the day and 
up to about three hours before bedtime, after which 
very little or none should be taken. The foot of the 
bed may be elevated at night. A cold sponge bath, 
followed by a brisk rubbing with a crash towel, 
should be taken on rising in the morning. 

Holt says that punishment of any kind should 
never be employed, as it is absolutely harmful, but 
he finds that a system of rewards, in the case of 
children, works well. If the child especially de- 
sires a doll, bicycle or pony allow him to have it, 
as long as the bed remains dry. A nickel for each 
night that remains dry is very helpful. With the 
above treatment the author has been very suc- 
cessful in overcoming this very annoying condition. 



Disease and Its Treatment 306 

CYSTITIS. 

(Inflammation o£ the Bladder.) 

This inflammation may be acute or chronic, and 
may be caused by gonorrhoea, unclean catheters, re- 
tention of urine, and colds. 

The symptoms are bearing down pains over the 
bladder, with tenderness in the same region on pres- 
sure. The urine is scanty and often highly colored. 
It may be tinged with blood and contains blood and 
mucus. 

Treatment. The patient should rest in bed, with 
the hips slightly elevated. Remove any lesions found 
in the lower dorsal an,d lumbar regions, and stim- 
ulate over the lumbar and sacral region. See Nos. 
51, 52, 57, 58. Should there be pain in the bladder 
inhibit in the above regions. See No. 67. Local 
abdominal treatment should be given, lifting up on 
the contents of the abdomen, especially the lower 
part. See Nos. 96, 97. Give a thorough general and 
inhibitive treatment to the bowels. This helps to 
draw the blood away from the bladder. See Nos. 
94, 95, 100. Treat in acute cases once or twice daily. 

Hot sitz baths and hot applications over the blad- 
<ier will be helpful. Use the liquid diet. Drink 
plenty of water. Peppermint tea is splendid. The 
medical treatment often recommended is to keep 
the bowels open with the use of salts. Irrigation 
of the bladder, with a soft rubber tube and a foun- 
tain syringe, using a two per cent solution of boric 
acid. A formalin solution is used for the same pur- 



306 Practice of Osteopathy 

pose, five to ten drops to a pint of water. In either 
case the water should be sterilized by boiling. 

UPEMIA. 

Is a poisoned condition of the syttem, which some- 
times develops in nephritis or anuria, due to the 
presence of toxic material, which should have been 
eliminated by the kidneys. It may also follow gout, 
scarlet fever and typhoid fever. 

The onset is sudden, the face is pale, pulse is slow. 
There is often a dropsical condition and the breath- 
ing is difficult. The urine is scanty and contains al- 
bumen. There is nausea, vomiting, delirium and 
convulsions. There may be paralysis. 

The treatment is administered for the purpose of 
stimulating the kidneys and skin to activity. Thor- 
ough work must be performed from the fifth dorsal 
to the second lumbar vertebra. See Nos. 43, 44, 
48, 51, 52. Treat the abdomen deeply and thorough- 
ly at and above the umbilicus. See Nos. 94 to 100. 
Treat the upper dorsal and neck region to stimulate 
the heart and lungs. See Nos. 53, 1, 5, 7B, 7C. 
Raise the ribs. See Nos. 81, 88. Treat strongly at 
the base of the skull. See No. 7B. Give a warm 
salt water enema, in which a tablespoonful of salt 
has been dissolved to each quart of water. Hot 
packs will help to induce sweating. 

Some medical authorities advocate active pur- 
ging, with the use of salts. To induce sweating use 
either the hot bath or give one-tenth of a grain of 
pilocarpine three times per day. 



Disease and Its Treatment 307 

ANURIA. 
(Suppression of Urine.) 

Anuria commonly means that the urine does not 
reach the bladder, a suppression of urine. Cases 
in which the suppression is absolute are very rare. 

The trouble may be caused by acute Bright's dis- 
ease, by lowered pressure of the blood, or when the 
fluids are depleted by diarrhoea. The ureter of a 
healthy kidney may be obstructed by pressure, or 
calculi may block both ureters. Severe injuries, or 
an operation, or lead, turpentine or phosphorus 
poisoning may act as a cause. Patients have lived 
for ten days with complete suppression of the urine. 
One writer records recovery after a suppression of 
nineteen days. 

Treatment should be given mainly to stimulate 
the spine at the tenth, eleventh and twelfth dorsal 
vertebrae. This may be extended from the sixth dor- 
sal to the second lumbar vertebra. See Nos. 43, 44, 
48, 51, 52. 

Draw the muscles away from the spine, as in Nos. 
31. Treat the abdomen in a thorough manner to 
draw the blood there and relieve congestion. See 
Nos. 94 to 100. The bowels should be kept open. 
The skin should be kept active by hot tub baths 
and hot packs. Hot salt water enemas should be 
taken. 



308 Practice of Osteopathy 



ADDISON'S DISEASE. 

This is an affection of the suprarenal glands. It 
is characterized by heart weakness, gastro-intes- 
tinal symptoms, and a bronzed condition of the 
skin. Medical writers claim the real cause to be 
unknown, but the disease has followed blows upon 
the back and abdomen; also caries of the spine. 
They say that the disease is fatal and recovery is 
unknown. It occurs mostly in men btween the ages 
of twenty and forty. Ninety per cent of those who 
suffer with this disease are laborers. 

Do not diagnose every case of pigmented skin 
as Addison's disease. Prostration is present before 
any other symptom and becomes more marked. 
Remember, that in cancer, tuberculosis, liver trou- 
bles, pregnancy, exophthalmic goiter, and in marked 
brunettes this bronzed condition is present. 

The patient may be kept in bed. A light diet, 
but nutritious, should be employed. Some prefer 
a strict milk diet. In some cases a light, agreeable 
form of exercise may be employed. 

This disease has been cured under Osteopathic 
treatment. A general treatment should be given, 
paying particular attention to the articulations of 
all the vertebrae. See general treatment. Lift the 
lower bowel from the pelvis. See paragraphs 96 
and 97. The patient should receive a treatment 
every other day for a while. 



Disease and Its Treatment 309 

CONGESTION OF KIDNEY. 

The osteopathic treatment will be the same as 
for anuria. Medical writers recommend a calomel 
purge of from five to ten grains, followed by a good 
dose of salts in a few hours. Warm baths and ene- 
mas are recommended. 

MOVABLE KIDNEY. 

Floating kidney, palpable kidney, nephrotosis, are 
terms used to denote the various degrees in which a 
kidney may be removed from its normal position. 
Its most common occurrence in women is due to the 
wasting of the fat tissues which hold it in place, 
weakness of the abdominal walls from repeated 
pregnancies, and tight lacing. In men it may be due 
to heavy lifting, strains, tumors, etc. 

With the patient lying on the back, the knee 
flexed, the operator stands at the left of the patient 
and with the left hand placed behind the eleventh 
and twelfth ribs on the right side, the right hand 
just below the liver over the upper abdomen, pres- 
sure may be made with both hands, and a hard, 
rounded body may be detected with a tendency to 
move upwards. It may be so low that the upper part 
of the kidney may be palpable, or it may be felt in 
the lower part of the abdomen. 

In most cases there are no symptoms. There may 
be nervous symptoms and dyspepsia. With the float- 
ing type there may be severe pain, chills, fever and 
vomiting with collapse. 



310 Practice of Osteopathy 

Treatment. Build up the patient. Increase the 
fat. See diet in tuberculosis. Give a general os- 
teopathic treatment three times per week. The kid- 
ney may be pushed up and an abdominal belt worn 
to hold up the abdominal contents, thus assisting in 
holding the organ in place. 

ACUTE BRIGHT'S DISEASE, 

(Acute Nephritis. Acute Inflammation of the Kid- 
neys.) 

Acute inflammation of the kidneys may be caused 
by exposure to cold and wet and to poisons 
generated by the acute infectious diseases, such as 
scarlet fever, measles, diphtheria, small pox, chicken 
pox, malaria, meningitis, tonsillitis, etc. It may 
also be caused by turpentine, cantharides, carbolic 
acid, and potassium chlorate. Pregnancy is also a 
cause, occasioned by pressure on the renal veins. 
Extensive burns are frequently followed by this 
disease. 

Symptoms. The urine is high colored and scanty. 
It contains blood and albumen. To test for al- 
bumen, boil a little urine in a test tube over a 
spirit lamp. If it becomes cloudy add a drop of 
nitric acid. Should the cloudy condition persist 
it indicates albumen, but if it clears up on adding 
the acid it is an indication of phosphates. The 
pulse is hard. The face, particularly under the eyes, 
and the ankles may be swollen. There may be pain 



Disease and Its Treatment 311 

in the back, with vomiting. There may be fever 
of from 101 to 103 degrees. The skin is dry. 

Treatment. Lesions should be looked for from the 
cervical region to the lumbar. Lesions found 
should be removed. Special stimulation should 
be given from the sixth dorsal to the second lumbar 
vertebra. See Nos. 34, 43, 44, 48, 51, 52. Work 
over the lower lumbar region and stimulate the 
sacral nerves. See No. 57. Give a thorough ab- 
dominal treatment at and above the umbilicus. See 
Nos. 94 to 100. Give an inhibitive treatment in the 
lower abdomen. Use hot tub baths and the hot 
packs. See hot packs. Until the patient is better 
treat each day. Later, three times per week will 
be sufficient. The patient should rest in bed. Use 
a liquid diet. Drink plenty of water, lemonade, 
mint tea and buttermilk. It would be best to live 
on an exclusive milk diet for several days. It 
should be sipped slowly. An adult needs from two 
quarts to four quarts daily. It may be diluted with 
vichy or carbonic acid water. If the milk can not 
be made to agree with the patient, gruels may be 
given, made of arrowroot, rice, oatmeal, etc., but 
vegetables and meat are interdicted. A splendid 
drink is a drachm of cream of tartar in a quart of 
boiling water. Add the juice of a lemon and a little 
sugar. Drink when cold. 

Orange juice, baked apples, stewed prunes, rice 
pudding and blancmange may be added later. Re- 
turn to a regular diet should be slow. Even then 
use plenty of milk and avoid highly-seasoned and 



312 Practice of Osteopathy 

spiced foods, rich foods, pastry, alcoholic drinks, 
tea and coffee. 

The medical treatment, if desired, would be to 
have the bowels kept active with calomel, followed 
by salts. In case the hot bathing and packs failed 
to induce sweating, give children one-twelfth to 
one-eighth of a grain of pilocarpine three times 
per day, and for adults one-sixth to one-fourth of a 
grain until the skin becomes active. 

CHRONIC BRIGHT'S DISEASE. 

There are two forms recognized, the chronic dif- 
fuse, or parenchymatous nephritis, and the inter- 
stitial nephritis, or cirrhosis of the kidney or con- 
tracted kidney. 

Symptoms. In diffuse nephritis the urine is 
scanty, high colored, cloudy and contains much al- 
bumen. In interstitial nephritis the urine is 
abundant, light colored and contains albumen. See 
the acute form. In both there are stomach and in- 
testinal disturbances, headache, loss of appetite, 
dropsy, puffing under the eyes, rapid heart beat, 
changes in the retina. The outlook is bad in both 
cases, but more favorable in interstitial nephritis. 

From the osteopathic standpoint the treatment 
will be along the same general lines as for acute 
nephritis, only it will be given from three to four 
times per week in hope of prolonging the patient's 
life. 

Systematic exercise out of doors is a good thing 



Disease and Its Treatment 313 

for a patient with this disease. He must be free 
from care and worry. Thoroughly masticate the 
food and do not overeat. Oranges, lemons, apples 
and stewed prunes will be helpful in keeping the 
bowels open. After the discovery of the disease 
it will be well to try a milk diet for two to four 
months. The milk may be thickened with tapioca, 
sago or rice. Large amounts of the milk may be 
taken in weak coffee or tea. From two to four 
quarts will be sufficient for an adult in a day. 
When a change is made to solid food it will be well 
to take some milk. Corn bread, sago, tapioca, rice, 
macaroni, fresh, green vegetables, bacon, butter, 
potatoes, olive oil, the white meat of chicken, raw 
oysters, clams and fresh fish, a little mutton or 
fresh beef may be taken. The patient is urged to 
drink plenty of water, both hot and cold, also 
lemonade, buttermilk, ginger ale and the cream of 
tartar drink advised in acute nephritis. 

DROPSY. 
(Ascites, Renal Dropsy.) 

Ascites is dropsical condition of the abdomen, 
due to the accumulation of fluid in the peritoneal 
sac. It is generally caused by some other disease 
or diseases. It may follow diseases of the liver, 
heart, lungs, kidneys, or it may be secondary to la 
grippe, fever, etc. It may be caused directly by an 
obstruction to the portal circulation or to an ab- 
dominal tumor. We look for lesions in the spine, 



314 Practice of Osteopathy 

in the upper lumbar and lower dorsal regions, also 
among the ribs. 

The treatment in general should be directed to 
the removal of the first cause, and in addition we 
should stimulate the kidneys. See treatment in 
Bright's disease. 

It will be well to give a thorough general treatment. 
See general treatment. Special attention should be 
given to the upper dorsal region. Work here will 
stimulate the skin. Give a deep abdominal treat- 
ment. See Nos. 94, 95. Treat the solar plexus. 
See No. 100. Manipulate and treat the limbs as 
in Nos. 113, 114, 116. Work over the liver and keep 
the bowels active. See Nos. 93, 101, 102. 

Renal Dropsy. This is an accumulation of fluid 
in cellular tissues and lymph spaces from the arter- 
ies and veins, and is caused by the failure of the 
kidneys to carry off the surplus fluid, as they fail 
to do in various kidney diseases. See acute and 
chronic Bright's disease. The main treatment is, 
of course, directed to the cure of the primary con- 
dition. Keep the kidneys well stim.ulated by treat- 
ment in the lower dorsal region. Give a thorough 
general treatment for the purpose of toning up all 
the tissues. This assists the general circulation 
and retards the flow of fluid out of the blood vessels 
into the lymph and other spaces. 



Disease and Its Treatment 315 

ARTERIOSCLEROSIS. 
(Atheroma.) 

This disease is a thickening of the walls of the 
arteries, due to chronic inflammation of the inner coat 
(intima). It is often hereditary. Gout, syphilis, 
rheumatism, alcoholism, high and fast living act as 
exciting causes. This disease is often a forerunner 
of heart, liver, and Bright's disease and apoplexy. 
One great cause of this disease is overeating. We 
eat too much. We keep it up too long. I agree 
v^ith George Cheyne, that every man after fifty, 
it v^ould be well to begin at forty, ought to lessen 
the amount of his food, and every seven years after 
lessen it sensibly and gradually, and at last descend 
out of life as he ascended into it, even into the 
Child's Diet. He says that this would keep the 
faculties and senses clear and keep us free from 
great and dangerous distempers. He further says: 
" Milk and sweet, sound blood differ in nothing but 
color. Milk is blood." 

Symptoms. They are obscure, but in many cases 
there is a hard, bounding pulse, difficult breathing, 
and insomnia. It generally appears after forty. 

Treatment. A general osteopathic treatment is 
indicated. See general treatment. Stimulate be- 
tween the second and fifth dorsal vertebrae. See 
Nos. 34, 38, 43. Raise the ribs. See Nos. 84, 86. 
Work over the liver. See Nos. 93, 101, 102. Give 
a thorough abdominal treatment. See Nos. 94, 95. 
Stimulate the solar plexus. See No. 100. 



316 Practice of Osteopathy 

Diet. Let the meals be taken regularly. Drink 
plenty of water between meals. Leave alcohol 
alone. Use vegetables rather than meat. If there 
are renal symptoms, skimmed milk is a most ex- 
cellent diet. 

PHLEBITIS. 
Inflammation of Veins.) 

This may be simple or it may be septic, or it may 
be septic with bacteria from some neighboring sup- 
purative process. The veins are firm and painful to 
the touch, and are surrounded by inflamed tissue. 
There is swelling and pain, with some heat. There 
is stiffness of the limb. The skin is discolored. 
Pressure, without or with injury, may act as a 
cause for this disturbance. Often there is no his- 
tory of violence or accident. Most simple cases 
occur in the lower limbs. Should it be in the pelvis, 
ear or portal vein, the condition is most grave and 
surgical assistance may be necessary. 

Treatment. The patient must rest, sometimes for 
a month or six weeks. When the trouble is in the 
lower limbs the trouble is looked for at the eleventh 
dorsal and below this point, as far as the sacrum. 
Remove the lesions as far as possible and give 
stimulating treatment in the lower dorsal and lum- 
bar regions. See Nos. 43, 44, 48, 51, 52. Rotate and 
manipulate the lower limb with great care, as in 
Nos. 113, 114. 

Give slight torsion about ten times each way per 



Disease and Its Treatment 317 

treatment, as in No. 121. Gently rub tissues of the 
limb in the direction of the heart. 

Diet. The diet should be light. Keep the limb 
elevated as much as possible. Hot fomentations 
may be applied for a while. Some medical authori- 
ties advocate the use of lead water, used as a cold 
compress. 

VARICOSE VEINS. 

Varicose or enlarged veins are more common in 
the lower limbs. In general they are due to an 
obstruction to the return circulation. The condi- 
tion may be partly caused by a diseased liver or 
heart, relaxed abdominal walls, and ptosis of the 
intestines. Constipation may help in increasing 
this disorder, as may a pregnant or misplaced 
uterus. The Osteopath looks for lesions in the 
lower dorsal and lumbar vertebrae, or in a slipped 
innominate bone which brings undue tension on 
some muscles and ligaments. 

Treatment. In general this is a stimulating one 
in the lower dorsal and lumbar regions. See Nos. 
43, 44, 48, 50, 51, 52. Manipulate the limb. See 
Nos. 113, 114, 121. Give abdominal treatment. See 
Nos. 94 to 100. Lift up abdominal contents. See 
Nos. 96, 97. If the heart or liver is involved, this 
calls for treatment for this special ailment. If 
constipated, see special treatment for that. 

Some medical writers order salts to keep the 
bowels open and order an elastic stocking. Under 
osteopathic treatment the elastic stocking may be 
removed. 



318 Practice of Osteopathy 



HODGKIN'S DISEASE. 

Adenia, General Lymphadenoma. 

An affection of the lymphatic glands, character- 
ized by progressive enlargement. Nodular growths 
also form in the spleen, liver and lungs. The en- 
largement usually begins on one side of the neck. 
Three-fourths of all cases occur in males. It is a 
disease of young and middle-aged people, from 10 
to 40 years. The medical profession have been unable 
to find a cause. The submaxillary and cervical 
glands are first noticed to be enlarging. These 
grow to be as large as a hen's egg or orange, and in 
months or years, lymphatic glands in the axillary 
and inguinal, and, it may be, other internal glands, 
enlarge. During the first stages of the trouble the 
general health seems fair, but as the disease pro- 
gresses the patient becomes pale and weak. There 
are headache, difficult breathing and disturbances of 
the stomach and bowels. There appears a chronic 
relapsing fever. Of course as the glands enlarge 
there will be various pressure symptoms, as the 
glands affect different nerves. The pressure of the 
axillary glands on nerves there will cause pain and 
swelling in the hands and arms. The inguinal 
glands, in the same manner, will be the cause of 
great pain in the limbs and swelling of the feet. 



Disease and Its Treatment 319 

Cough, pain and difficult breathing will be the result 
of swelling mediastinal glands. Tuberculosis is so 
often present that it is thought to be one cause of 
the trouble. In young persons it is difficult to de- 
termine whether it is Hodgkin's disease or tuber- 
culosis when the glands of the neck begin to swell, 
but more frequently it is tuberculosis. When there 
is considerable progress in the disease the patient 
becomes greatly emaciated. 

In some cases the enlargement of the glands pro- 
gresses rapidly and the case ends fatally in three or 
four months, but under medical treatment we ex- 
pect the patient to last two or three years. 

In treating this disease the Osteopath desires to 
secure an unobstructed circulation of the blood, 
lymph and nerve supply, for he believes that this 
disease, as most other troubles, is the result of the 
obstruction of these functions of nature. An ob- 
struction of these forces occurring, the lymph and 
blood stream grows stagnant and proves an ex- 
cellent breeding ground for any pathogenic germ. 

The Osteopathic treatment is given by thor- 
oughly treating the neck (see treatment of the neck, 
paragraphs 1, 2, 3, 4, 5, 9, 11, 13), the object being 
to secure a thorough relaxation of all the tissues of 
the neck. The clavicles are raised as in paragraphs 
72 and 73. The ribs are adjusted as it is found nec- 
essary from the examination. See paragraphs 74 
to 89. The spine is treated as in paragraphs 48 to 
64, using such treatments as are indicated from the 
examination. Treat over the abdomen. See treat- 



320 Practice of Osteopathy 

ment of the abdomen. Remove all lesions where 
found and look for some spinal curvature. Lift up 
the glands carefully, so as to improve the circula- 
tion, and hold for a few minutes. Do not handle 
these glands roughly, as it is easy to injure them. 
In treating, after the manner described, we expect 
to stop the course of the disease and to secure im- 
provement, with sometimes a cure. 



Disease and Its Treatment 321 



THE HEART. 

In treating all diseases the Osteopath is very much 
concerned in securing a free passage for lymph, blood 
and nerves, for he knows that if the nerve and fluid 
circulation is free in every way the patient will soon 
regain his health. The arterial system should be kept 
free and the venous return should be unimpeded on 
its way back to the heart and lungs for purification. 
The obstruction of the return circulation is a very 
prolific cause of disease. When the impure blood is 
held back, in or near any organ, it stagnates, ferments, 
is the cause of hypertrophy and furnishes a breeding 
place for germs. 

When there is an obstruction to the circulation, in 
or near any organ, due to mechanical maladjustment 
of some part of the anatomy, or in the capillary sys- 
tem, due to arteriosclerosis, an added burden is placed 
upon the heart to supply all parts of the body with 
blood. This extra burden often leads to hypertrophy. 
So important is the work of the heart in keeping the 
body well nourished with blood and keeping the blood 
in motion that we ought to be well informed as to its 
anatomy, nerve supply and physiological functions. 

In nearly all cases of heart disease we find some 
pressure on the pneumogastric nerve. We remember 
that this nerve supplies both the heart and lungs. It 



322 Practice of Osteopathy 

also goes to the stomach. When the lungs or stomach 
do not perform their work properly an extra burden 
is thrown upon the heart. Disorders of the stomach 
often result in palpitation of the heart. So in treating 
cases of heart disease we must carefully examine 
other organs and lesions which will affect them. 
Special attention is given to following the courses of 
all the branches of the pneumogastric nerves. In 
giving Osteopathic treatment we must look for first 
causes before giving the treatment. Unless we know 
and treat by removing these causes we may do more 
harm than good. This is especially true in treating 
heart troubles. 



Disease and Its Treatment 323 

FATTY DEGENERATION OF THE HEART. 

(Fatty Infiltration of the Heart.) 

The heart muscles may be infiltrated with and 
largely converted into fat. There may be a fatty 
overgrowth, in which large amounts of fat are de- 
posited in and about the heart. Of course this 
condition greatly weakens the heart. The oste- 
opathic treatment is given with a view of stimu- 
lating and overcoming the condition. The nerve 
supply to the heart and vessels is corrected at the 
same time. This increases the strength of the beat 
and the general heart tone. The stimulation is 
given in the area of the second to the fifth dorsal 
vertebra. See Nos. 34, 43. The sympathetic gan- 
glia in the neck are also stimulated. See Nos. 7C, 
also 1, 5, 7B. The ribs are to be gently raised. See 
Nos. 82, 86. A light general treatment, including 
the above, may be given three times per week. 
See general treatment. This will build up the 
general health. The diet should be nutritious, yet 
it ought to be light. Take the largest meal at noon. 
The patient should not be allowed to have fat, 
rich foods, cheese, goose, duck, sausage, cabbage 
and beans. 

Exercise should be light, yet it may be gradually 
increased. Graduated exercises in hill climbing 
have been recommended. They should be carefully 
performed. The patient should be instructed in 
deep breathing, which see. 



324 Practice of Osteopathy 

VALVULAR LESIONS OF THE HEART. 

The outlook in most cases presenting valvular 
difficulties is not favorable, yet a number of cases 
have been cured by osteopathic procedure. At any 
rate, most cases may be benefited. Should these 
cases arise from lessened contractile power, or dil- 
atation, the prognosis is very fair. 

In the treatment we should look for spinal and rib 
lesions which have weakened the heart. These 
should be corrected. In general the patient will be 
treated as for pericarditis, omitting all inhibition. 

The patient should lead a quiet, even life. All 
strenuous exercise should be prohibited. The 
bowels should move each day. Keep the body free 
from sudden changes of temperature, by the use 
of light woolen. The diet may be generous, but 
rich and heavy articles of food should not be eaten. 
Omit pastry. Do not take Turkish or Russian 
baths. Do not go into high altitudes. Cool sponge 
baths are good. Walking is splendid exercise. 

Conservative medical treatment, in the early 
stages, would assist digestion with five drops of 
dilute hydrochloric acid in sweetened water after 
each meal. 

PERICARDITIS. 

This is an inflammation of the pericardium. It 
may be caused by the passage of a foreign object 
through the oesophagus or by arthritis, tonsillitis, 
rheumatism, necrosis of bone, puerperal fever, 



Disease and Its Treatment 325 

chorea, Bright's disease, pneumonia, scarlet fever, 
tuberculosis, gout and arteriosclerosis. 

The patient should have rest. He should be quiet 
mentally as well as physically. The best treatment 
is osteopathic. It is given to quiet the heart's ac- 
tion. We look for lesions of the first and second, 
fourth and fifth ribs and of the clavicles, all affect- 
ing the drainage of the pericardium. Stimulate the 
vagus nerve. See Nos. 7, 72, 73. This will inhibit 
the heart's action. Inhibit the spine from the 
sixth cervical to the sixth dorsal. See No. 67. The 
pressure here for inhibition should be prolonged. 
It is done while the patient is lying on the back 
with the left arm raised and held well above the 
head. See No. 61. Raise the ribs carefully. It 
gives the heart greater space in which to work and 
secures better drainage from the heart. See Nos. 
82, 86. Work deeply and slowly over the abdomen 
and inhibit the spine from the tenth dorsal to the 
second lumbar. This draws the blood to the ab- 
dominal vessels and relieves the heart. See Nos. 
67 , 94, 100. Treat once or twice daily. 

The ice bag should be applied over the heart an 
hour at a time with intermissions of ten minutes. 
Later keep it there continuously. Keep the air 
out of the bag as much as possible. The diet should 
be light and liquid, 



326 Practice of Osteopatliy 

TACHYCARDIA, BRACHYCARDIA, ARRHY- 
THMIA. 

Tachycardia is a rapid beating of the heart, but 
without special sensation to the patient. Brachy- 
cardia is a slow beating of the heart without any 
noticeable sensation to the patient. Arrhythmia is 
an irregular beat, during which a beat may be 
skipped at intervals. 

The rapid heart beat would be treated osteopathic- 
ally the same as palpitation, which see. The brachy- 
cardia is treated the same, except the region be- 
tween the second and sixth dorsal is stimulated 
instead of being inhibited. Always remove lesions 
wherever found. 

Arrhythmia calls for the same general treatment. 
For an irritable heart treat the same as above. In 
all the above cases the patient should avoid alcohol, 
tea and coffee. The patient should not allow him- 
self to become excited. The diet should be light. 
Articles of food which have a tendency to produce 
gas should be left out of the diet list. 

PALPITATION. 

Palpitation of the heart is a rapid beating percep- 
tible to the patient. It may be accompanied with 
difficult breathing, increased force, irregularity, pain 
and anxiety. It is a sign of weakness when we are 
conscious of the heart beat, even though it be nor- 
mal otherwise. 



Disease and Its Treatment 327 

Some of the secondary causes are the excessive 
use of coffee, tea, alcohol or tobacco. It may occur 
after some fevers. It may accompany neurasthenia, 
hysteria or dyspepsia, especially when the stomach 
fills with gas. It has been noted at time of puberty, 
or the climacteric, and in some forms of functional 
trouble at menstruation. 

The Osteopath looks for the primary cause in 
some anatomical maladjustment of the atlas or axis, 
first and second vertebrae, or one or more of the 
first five ribs, or the clavical. The upper spinal 
muscles may be abnormally rigid. The entire thorax 
may be too small on account of the ribs having too 
much downward slant. 

Treatment. At the time of the attack the left 
hand of the patient may be held above the head and 
a steady pressure or pull be brought to bear on the 
second to fourth spinal vertebra. Continue this 
for five or ten minutes. See No. 67. Raise the ribs. 
See Nos. 82, 86, 87. Give a deep, inhibitive abdom- 
inal treatment for the purpose of relaxing the caliber 
of the abdominal vessels and drawing the blood 
there, thus quieting the heart's action. See Nos. 
94, 95, 100. Stimulate the pneumogastric nerve. 
See No. 7. Raise the clavical. See Nos. 72, 73. 
Apply an ice bag over the heart. Should the atlas 
or axis be out of position, correct. See Nos. 1, 3. 
Loosen the upper spinal muscles. See Nos. 34, 43, 
53. If the case is a chronic one give a treatment 
three times per week. 



328 Practice of Osteopathy 

ENDOCARDITIS AND MYOCARDITIS. 

These diseases are inflammation of the endo- 
cardium and myocardium. Both are very grave 
diseases, owing to the pathological changes taking 
place. The simple endocarditis is frequently cured. 
The treatment in both cases is the same as for peri- 
carditis, with special attention to any specific lesion 
in the anatomical location named. See pericarditis. 

ANGINA PECTORIS. 
(Stenocardia, Breast Pang.) 

These are paroxysms of intense pain over the 
heart region, which radiate to the neck, back and 
arms, generally to the left arm. It is associated 
with disease of the heart and vessels. There is a 
sensation of impending death. The attack usually 
comes on during some muscular exertion. It may 
be induced by cold, excessive anger or excitement. 

Treatment. Inhibit at second to sixth dorsal 
vertebra. See No. 67. Loosen all tissues over the 
heart. Raise the ribs on the left side. See Nos. 
82, 86. Treatment should be given afterwards to 
remove any lesions causing heart trouble. See 
pericarditis. Pay special attention to the bowels 
and kidneys. A quiet life should be led and the 
sleeping room should be cool. Do not overexert, 
and avoid excitement. Do not eat heavy, indigest- 
ible food. 

Medical authorities advise if the patient is sub- 



Disease and Its Treatment 329 

ject to the disease for him to carry a vial of amyl 
nitrite. When the attack seems pending inhale 
from two to five drops by dropping it on a handker- 
chief. This failing, inhale chloroform. 

HYPERTROPHY OF THE HEART. 
(Enlargement of the Heart. Dilatation of the Heart.) 

This condition is due to a strain of the heart 
muscles. It may be due to prolonged overexertion. 
It is sometimes caused by valvular disease, due to 
nature's effort to normalize the defect. Exoph- 
thalmic goiter is a frequent cause. Obstruction of 
the circulation in the small arteries adds a burden 
to the heart's work. Nephritis, hepatitis and em- 
physema increase the heart's labor and are respon- 
sible for some cases. Alcohol, tobacco, coffee, and 
lead poisoning are sometimes responsible. 

The treatment, of course, demands the removal 
of the primary cause, and if that cause is some dis- 
ease then that needs treatment. The same care as 
to diet and general living is necessary as in valv- 
ular heart troubles. Lesions should be removed 
as in pericarditis, which see. 

ANEMIA. 

(Secondary Anaemia. Toxic Anaemia.) 

Anaemia is a term which is used to define any 
marked change in the blood, in the number of 
either white or red corpuscles, or in the amount of 



330 Practice of Osteopathy 

the hsemaglobin, or albumen. It may be used to 
denote a deficient quantity as well as quality of the 
blood. 

Secondary anaemia refers to anaemia resulting 
from loss of blood, due to hemorrhage. Toxic anae- 
mia is caused by the action of poisons on the blood, 
as mercury, arsenic, lead and the poisons of syph- 
ilis, malaria, etc. For treatment, see Progressive 
Pernicious Anaemia. 



Disease andl Its Treatment 331 



CHLOROSIS. 

Green Sickness. 

This is a special form of primary anaemia which 
frequently affects girls, generally between the ages of 
fourteen and eighteen. It is associated with unde- 
veloped vascular and generative systems. There is no 
loss of fat and the patient has a greenish-yellow tint 
of the complexion, from which the disease takes its 
name. 

This condition dates from a scanty menstruation, 
which begins late, and therefore it appears to be con- 
nected with the evolution of the sexual life. It is 
hereditary, and if the mother's side of the family 
have tuberculosis the girls are liable to this disease. 
It is common among poor and overworked factory- 
girls. Bad air, lack of outdoor exercise, rest and 
sleep, irregular eating and poor food all predispose to 
this disease. 

The symptoms are fatigue and indisposition to 
mental or physical activity in the beginning of the 
trouble. Palpitation of the heart, difficult breathing, 
headache, constipation and scanty menses soon be- 
come prominent symptoms. The appetite is poor. 
The tongue is pale and dry and there is vertigo. The 
fat may be increased and the person maintain her 



332 Practice of Osteopathy 

rotundity. But there is the peculiar color which may 
vary from the characteristic greenish shade to safifron, 
lemon-yellow, or muddy tint. There may be some 
irregular fever, nervous symptoms, mental depression 
and oedema of the ankles. 

The prognosis is favorable under Osteopathic treat- 
ment. We should begin the treatment carefully, and 
not give it too severely at first. It would be well to 
give a gentle general treatment each day for about 
one week before searching for definite lesions. See 
general treatment. Look for lesions in the innomi- 
nates, spine and ribs. If the treatment is followed 
carefully and persistently for some time we may ex- 
pect the best of results. 

The diet and hygiene should be carefully looked 
after. There should be plenty of fresh air, rest and 
sleep, with regular habits. Change of location or a 
trip to the sea or mountains will be helpful. If the 
girl is an indoor worker a change of occupation to 
out of doors should be tried. Plenty of easily-di- 
gested food should be allowed: green vegetables, 
stewed and fresh fruit, milk, eggs, fish and meat. 
Leave tea and cofifee alone. A warm bath three times 
per week is indicated. 

PROGRESSIVE PERNICIOUS ANEMIA. 

(Idiopathic Anaemia.) 

This is usually defined as a grave disease of the 
blood, in which there is destruction of red corpus- 



Disease and Its Treatment 333 

cles. The cause is unknown and the condition 
grows worse. There is pallor, shortness of breath, 
palpitation of the heart. The patient is tired. The 
white of the eyes is pearly. The pulse is large but 
soft. There is headache and vertigo. The food is 
repugnant. The skin assumes a lemon yellow color. 
The patient becomes more feeble and the flesh more 
soft and flabby, and the bed is soon taken. Fever 
is moderate. The tendency is towards paralysis. 
The ankles swell slightly. Under osteopathic treat- 
ment the procedure is about the same as in all 
cases of anaemia. 

Treatment. The spine is to be carefully examined 
and all lesions are to be removed as fully as pos- 
sible. The treatment is general. See general treat- 
ment. The treatments must be given lightly at first, 
and as the patient improves they may be given with 
more force and at greater intervals. At first the 
treatment should be given daily, later three times 
per week. This may be reduced to twice and once 
per week as the patient improves. The treatments 
should be continued for a long time. Keep the 
heart stimulated. See Nos. 34, 43, 7C. Constipation 
and headache should be treated as indicated as 
under those general heads. 

Diet. Strict attention should be given to the diet. 
As the patient can handle it, good, nutritious food 
should be provided. See diet of tuberculosis. Let 
there be good ventilation. Out of door sleeping 
would be better. Take plenty of time for sleep. 
Keep regular hours. Exercise moderately. Give up 



334 Practice of Osteopathy 

school for a time and avoid all social functions. 
Hot baths may be taken twice per week. Take a 
cold sponge bath, followed by brisk rubbing, each 
morning. 

Medical Treatment. The bowels should be given 
attention and should be made to move daily. In 
chlorosis Blaud's pills are given, which contain 
two grains of the sulphate of iron. The pills are given 
in increasing doses. The first week one pill three times 
per day. The second week two pills three times 
per day. Third week three pills three times per 
day. This latter is kept up for three months. 

In progressive pernicious anaemia arsenic in in- 
creasing doses is used. Three drops of Fowler's 
solution three times per day is increased to five 
drops at the end of the first week, ten at the end of 
the second week and fifteen the third week. Vomit- 
ing and diarrhoea are symptoms of an overdose. 

Five to ten drops of dilute hydrochloric acid may 
be given, in all cases, in water, after each meal to 
aid digestion. 

GOITER, SIMPLE. 
(Big Neck. Bronchocele.) 

This disease is an enlargement of a whole or a 
part of the thyroid gland. The causes of this disease 
have been variously given by different medical 
writers. Those given, however, are the exciting 
or secondary causes. The disease is much more 
frequent in women than in men. The goiter in- 



Disease and Its Treatment 335 

creases in size at the menstrual period, and during 
each pregnancy it becomes larger. It is more prev- 
alent in limestone regions and often hereditary. 

The growth is painless, but may cause difficult 
breathing, difficult swallowing or loss of voice. It 
has caused sudden death by pressure on the vagi 
nerves. 

The outlook under medical treatment is unfavor- 
able, guardedly favorable as to life, but the disease 
is generally cured by osteopathic treatment. The 
real cause of the disease is an interference with 
the nerve and blood supply of this very vascular 
gland. 

The neck should have the tissues thoroughly 
loosened, both front and back. See Nos. 1, 5, 6, 8B. 
9, 10, 11. The cervical vertebrae should be lined up 
if found out of position. See Nos. 1, 3. The clavi- 
cles should be raised. See Nos. 72, 73. Depress 
the first rib. See Nos. 75, 76, 77. But little work 
should be done over the goiter, but it may be 
raised up gently at each treatment. See No. 8B. 
In many cases a general treatment will be helpful. 
See general treatment. Treatment may be given 
two or three times per week at first. When improve- 
ment is marked only once per week is indicated. 

EXOPHTHALMIC GOITER. 

(Graves* Disease. Basedow's Disease.) 

This disease not only presents the large neck 
(thyroid gland), but there is a protrusion of the 



336 Practice of Osteopathy 

eyeballs, a rapid heart, and a peculiar muscular 
tremor. The pulse may be from 100 to 160. The 
breathing, on exertion, is difficult. 

This disease often yields quite readily to oste- 
opathic treatment. The procedure is the same as 
for simple goiter, which see. In addition to this a 
general treatment is to be recommended as for 
nervousness. See general treatment. A wet pack 
may be placed about the neck at night. The patient 
should avoid excitement and should rest in a re- 
clining position a great deal. 

PARALYSIS. 

Hemiplegia, paralysis of one side of the body; 
paraplegia, paralysis of the lower part of the body. 
In the various forms of paralysis, regardless of what 
may seem to be the cause, we are to look for lesions 
in every part of the spine, the ribs, the hips, the 
innominates and coccyx. When these lesions are 
found they are to be removed. The lesions in the 
neck, of the atlas and axis, are very important. 
Here may be the cause of paralysis in either arm or 
in any part of the body below this lesion. 

Very many cases of paralysis, including all the 
types, from infantile to all the more severe types 
of the aged, have been greatly benefited and cured 
by Osteopathy. 

In connection with the specific treatment for the re- 
moval of the lesion, a general treatment should be 
given. See general treatment. Give special atten- 



Disease and Its Treatment 337 

tion to the neck. See Nos. 1, 3, 5, 9, 10, 11. Attend 
to the clavicles. See Nos. 72, 73. Spinal treatment 
will be necessary. See Nos. 34, 35, 36, 37, 38, 41, 
48, 50, 52. 

In some cases it is necessary to give the treat- 
ment for months in order to get a good blood supply 
to the nerve centers for the purpose of regenerating 
them and the nerves most affected. 

The general health must be looked after. Partic- 
ular attention should be given to the kidneys, 
bov^els, liver and stomach. The affected limb or 
limbs should receive a thorough local treatment. 



338 Practice of Osteopathy 

INFANTILE SPINAL PARALYSIS. 

Acute Poliomyelitis. 

This disease comes on and develops very quickly. 
The child may have symptoms of fever, with tem- 
perature of from 100 to 103 degrees, with some 
stomach trouble one day, and the paralysis may reach 
its height the following day. The symptoms vary 
greatly and there is no certainty of making a correct 
diagnosis until the paralysis appears. A child may 
retire at night in apparent health and awaken in the 
morning with paralysis. Boys are more subject to 
the disease than girls, and the cases are more com- 
mon in the warm months. Over eighty per cent 
of the cases occur before the patient reaches the age 
of five, but a few young adults have the disease. 
There is almost no pain and there are no sensory 
disturbances. If the paralysis persists for a long 
time there is great muscular wasting in the part 
affected. In many cases there is recovery of most 
muscles without treatment of any kind, but a group 
of muscles almost always remains permanently 
paralyzed. These are often in one arm or one leg. 
In one to four weeks there will not be much change 
in the aflected muscles, but in the following three 
months there will be some improvement and the 
paralysis that remains will most likely be permanent. 
Some have been greatly benefited when one and 
sometimes two years have elapsed since first being 
taken with the malady. 



Disease and Its Treatment 339 

The Osteopathic treatment should be commenced 
early. If begun at once we may hope to stop the 
inflammation in the spinal cord and limit the destruc- 
tion of nerve cells. When these are destroyed we 
can only hope for a partial recovery. The part of 
the cord involved may be determined by the portion 
of the body affected. If the leg, look for trouble 
from the eleventh dorsal through to the lumbar por- 
tion of the spine. If an arm is affected, we expect 
the cervical and upper dorsal portions of the spine 
to be affected. Administer the treatment carefully 
at first. See the treatments for the neck and spine. 
Keep the limbs warm. Put them through a passive 
motion, at least three times per day. Friction and 
massage will be of great value in keeping up the 
circulation and should be given twice daily for a 
long time. Some writers recommend that a spinal 
ice bag be used in the early stages of the disease. 
This tends to keep down the inflammation of the 
cord and at the same time helps keep the extremities 
warm. Do not use braces if you can possibly get 
along without them. The circulation is better and 
the improvement is more noticeable when the af- 
fected parts are entirely free. When there is a great 
deal of weakness braces often help one to get about 
and may be used in old cases. 

In cases which are of several years' duration we 
do not expect to do much, but by giving the spinal 
treatment there will be improvement for a year or 
more. We never expect a complete cure. 



340 Practice of Osteopathy 

APOPLEXY. 

Cerebral Hemorrhage. 

There are two forms of apoplexy: One, from the 
rupture of a blood vessel, intracranial hemorrhage; 
and two, thrombosis or embolism, which is occasioned 
by accute softening of the brain. The brain, soften- 
ing, does not give the proper support to the walls of 
the blood vessels. This is accompanied by endarter- 
itis, in which the lumen of the vessels is obliterated 
and embolism and rupture is the result. 

This trouble is more common after the fiftieth 
year, but may happen in children of ten. Men are 
more liable to this disease than women. Among the 
many causes might be mentioned, the overactivity of 
modern life. There are many men who have at- 
tained the age of fifty years and have not been guilty 
of doing any of the things that ordinarily lead to this 
trouble. They have been temperate in eating and 
drinking and have not had any venereal diseases, 
nor have they had gout, but they have had apoplexy 
as a result of high-pressure living. They have been 
at a high tension attending to business and social 
duties all day and a part of the night, without suffi- 
cient time for needed rest. They find themselves at 
last with hardened arteries and some form of kidney 
trouble. 

Overeating is another cause of apoplexy. There 
are many cases of apoplexy for which there is no 
other cause. Men really dig their graves with their 
teeth. We may harm ourselves by overeating as 



Disease and Its Treatment 341 

well as by being intemperate in the use of liquor. 
We need to heed the advice of that old-time physi- 
cian, Dr. George Cheyne, who said : " Every wise 
man, after fifty, ought to begin to lessen the quantity 
of his aliment, and if he would continue free of great 
and dangerous distempers and preserve his senses 
and faculties clear to the last he ought, every seven 
years, to go on abating gradually and sensibly, and 
at last descend out of life as he ascended into it, 
even into the child's diet." This advice, if followed, 
would ward off a number of diseases, including 
stomach troubles, obesity and kidney diseases. 

Chronic Alcoholism, gout and lead poisoning are 
also important factors in causing this disease. They 
change the quality of the blood, and this in turn 
affects the arteries. They also set up renal changes 
which affect the blood and arteries as well. In most 
persons alcohol conserves fat, and this infiltrates in 
the walls of the blood vessels and weakens them, 
allowing the blood to force its way through. 

Prolonged Muscular Exertion is a cause. This 
hardens the arteries by raising the peripheral resis- 
tance, thereby increasing the blood pressure, which 
gradually weakens the arteries. 

Undue Blood Pressure in the brain is a great 
cause of apoplexy. The brain is a great storehouse 
of energy and nerve force. From it emanate thous- 
ands of nerve fibers, controlling every function of 
the body. This great work on the part of the brain 
requires an enormous amount of nutrition and elimi- 
nation. This is especially true when the man is a 



342 Practice of Osteopathy 

brain worker. This brain nourishment is conveyed 
through the arteries, veins, capillaries, lymphatics 
and serous channels which reach the head through 
the neck. We find surrounding the neck vertebrae 
more than thirty neck muscles, together with liga- 
ments. 

In and between these muscles lie the arteries and 
veins that convey the blood to and from the brain. 
The blood is pumped under direct pressure of the 
heart walls of the arteries. But the return blood, 
through the veins, which have thin walls, is under 
light pressure and may be held back by obstructions 
in the neck until undue pressure is exerted by the 
blood in the vessels of the brain. This pressure 
often results in the rupture of capillaries, which 
means apoplexy and paralysis, depending on the 
amount of blood escaping into the brain tissue and 
the seat of the lesion. In young persons we expect 
the capillaries to be more elastic and not to rupture 
so easily as in the case of older people. 

When there is normal relaxation of the muscles of 
the neck there is normal circulation to and from the 
brain. When there is contraction of the muscles, the 
return flow from the brain is impeded, while the 
heart is still forcing the blood under increasing pres- 
sure through the arteries to the brain. This causes 
heavy, expanding pressure in the capillaries of the 
brain tissue. The blood cannot return fast enough 
through the veins on account of interference in the 
neck. The pressure rises higher and the capillaries 
break, the oozing blood forms a clot and apoplexy 



Disease and Its Treatment 343 

is the result. Overexertion, a little excitement, 
brings on the attack without the least warning. 

Symptoms. Before the attack it is very rare to 
have any warning symptoms. The symptoms of the 
attack vary very much in different individuals. The 
loss of consciousness may be sudden and complete 
or it may come on slowly. In many cases the face 
is cyanotic, pupils are dilated, one more than the 
other. The respirations are slow and noisy. The 
pulse manifests increased tension and is slow and 
full. The temperature is normal or subnormal, ex- 
cept in cases of basal hemorrhatge, when it is fre- 
quently high. The head and eyes are often turned 
toward the side on which the hemorrhage exists. 
The muscles on the paralyzed side are flaccid. On 
elevating the paralyzed limb it will fall more quickly 
than the other. If bed sores develop within forty- 
eight hours it is a very bad sign. If the patient im- 
proves there may be paralysis on one entire side of 
the body. This paralysis will be more severe in some 
parts than in others, the arm being usually worse 
than the leg. The paralysis of the throat may be so 
severe that the patient can not swallow, and the 
tongue deviates to one side. The reflexes are in- 
creased after a week or so. When the patient begins 
to walk he drags the foot of the affected limb. 
There may appear a condition in which there is 
secondary contraction of the muscles, more especially 
of the arm, with considerable pain. 

Diagnosis. It is sometimes difflcult to diagnose 
this condition. When it is coming on slowly and 



344 Practice of Osteopathy 

consciousness is not lost the apoplexy is sometimes 
not recognized. When you first see the patient and 
he is in a deep coma it may be the result of epilepsy, 
alcoholism, ursemia, or diabetes. Doctors in hospital 
practice need to be very careful in passing upon 
patients who are admitted in an unconscious con- 
dition when they have the smell of liquor upon the 
breath. Many are drunk at the time of an attack. 
Such cases should be regarded as serious and not as 
simply alcoholic coma. 

Prognosis is very difficult to make with any de- 
gree of certainty. When the hemorrhage is slight 
the patient may entirely recover. When the paraly- 
sis persists for six months some grade of permanent 
palsy will remain. When the condition was first 
caused by an embolism stopping in a principal artery 
and shutting off the blood supply of a portion of the 
brain, resulting in softening, the outlook is serious. 

Treatment. The patient should be kept quiet. 
The head of the bed should be raised. Place an ice 
bag at the head and use hot water bottles at the feet, 
not too hot. Place the patient on his side, changing 
from one to the other. This is for the purpose of 
avoiding pneumonia. The bowels should be moved 
freely and a good movement secured every day. It 
is significant that Dr. Osier says : " No medicine 
should be administered, at least during the first 
month after hemorrhage." 

The Osteopathic treatment may be given at once. 
The muscles of the neck may be gently and 



Disease andl Its Treatment 345 

thoroughly relaxed while the patient is in the recum- 
bent position. See paragraphs 5 and 10. Also 
loosen the muscles in the suboccipital region, as in 
paragraph 7B. Keep the spinal tissues relaxed 
(see paragraph 53), also treat the muscles of the 
spine while the patient lies on his side as shown in 
Figs. 59 and 31. Give inhibitive treatment over the 
abdomen, as in paragraphs 94 and 100. This treat- 
ment should be given twice per day at first, gradually 
diminishing until two treatments are administered 
per week. The paralyzed limbs should be treated 
and massaged to prevent contraction of the muscles. 
The joints of the elbow and shoulder may be kept 
from ankylosis by properly manipulating them. 

The diet should be very light for some time, at 
least one month. Fruit juices are to be preferred. 
Light broths may be used. The patient should al- 
ways, as long as he lives, be underfed rather than 
overfed. Avoid meat and all nitrogenous food. Do 
not drink more than one and a half quarts of water 
daily. The object is tO' keep down the amount of 
blood as much as possible. 

Avoid all excitement as much as possible, live 
quietly and do not overexert, either mentally or 
physically. Do not use intoxicants. The patient is 
often easily irritated, but he should avoid becoming 
angry. A cheerful, happy and hopeful disposition 
should be cultivated. Some light mental occupation 
will be beneficial, but it should not be persisted in 
when the patient becomes weary. 



346 Practice of Osteopathy 

INSOMNIA. 
(Sleeplessness.) 

Insomnia may be due to various causes. Con- 
gestion or anaemia of the brain, Bright's disease, 
liver, stomach and intestinal disorders may cause 
sleeplessness, or it may be due to nervousness or 
excessive headache. The Osteopath believes, and 
has splendid success in following it out to its legiti- 
mate conclusions, that the basis of the trouble may 
be found in some bony, ligamentous or other lesion, 
that disturbs the circulation and allows pressure to 
disturb proper nerve function. A large number 
of these cases are met and successfully overcome 
by the Osteopath. Frequently an improvement is 
noted with the first treatment. In many cases but few 
treatments are required. 

In treating for this disorder the Osteopath looks 
for neck and upper spinal lesions. He pays partic- 
ular attention to the clavical and two upper ribs. 
See Nos. 72, 73, 75 to 81. 

Fully relax all spinal tissues. See Nos. 34, 36, 43, 
44, 53. Give a strong abdominal treatment. See 
Nos. 94 to 100. After the specific lesions, that are 
found, are treated, a general treatment is in order. 
See general treatment. 

When the person is excitable and there is a feel- 
ing of distension in the head, it will be well to keep 
the bowels regular. See the treatment for consti- 
pation. At night before retiring a hot bath, fol- 
lowed by a cool sponge bath, will be beneficial. 



Disease and Its Treatment 347 

Another help is a cold pack applied to the abdomen. 
This soon becomes warm and draws the blood there. 
See cold pack. Ten minutes of good, cool, pure air, 
breathed properly, will materially assist in gaining 
needed rest. See correct breathing. It is often rec- 
ommended that a glass of warm milk be taken just be- 
fore retiring. Medical writers recommend a dose of 
trional, ten to twenty grains, to be given with food 
half an hour before retiring. 

If the insomnia is caused by anaemia of the brain 
the patient is apt to start sleeping very well, but 
wakes later and can not fall asleep again. In ad- 
dition to the osteopathic treatment as outlined 
above, cold water or ice, then hot water, may be 
applied to the spine in long rubber bags, each for 
fifteen minutes. For this form of insomnia medical 
treatment would recommend some form of stimu- 
lant at bed-time, say one-sixtieth of a grain of 
strychnine, or some form of alcoholic drink. 

NEURALGIA. 

(Facial Neuralgia, Brachial Neuralgia, Intercostal 

Neuralgia, Spinal Neuralgia, Neuralgia of 

the Stomach, Tic Douloureux.) 

Neuralgia is a severe pain along the course of a 
nerve, unaccompanied by any change in the body 
of the nerve. 

The Osteopath usually finds some bony or mus- 
cular lesion causing pressure on the nerve or on 
some of its connections. A misplaced vertebra is 



348 Practice of Osteopathy 

a very common cause. In cases of facial neuralgia 
we expect to find contracted muscles in the neck 
or a misplaced atlas or axis, the first and second 
cervical vertebrae. Treatment for this would be as 
in Nos. 1, 3, 5. In brachial neuralgia, which in- 
volves the arm and shoulder, we look for lesions 
from the first cervical to the sixth dorsal. This will 
be treated as in Nos. 1, 3, 5, 9, 10, 11, 34, 43. All 
the upper spinal and neck tissues will be relaxed 
as in Nos. 5, 83, 34. Intercostal neuralgia is easily 
handled and is frequently caused by a twisted or 
misplaced rib or ribs too close together. Treat as 
in Nos. 75 to 89. Thoroughly relax all spinal tis- 
sues, as in Nos. 35, 36, 47, 48, 50. 

Spinal neuralgia and neuralgia of the stomach 
will be caused by misplaced vertebrae, the stomach 
lesions occurring from the fourth to the eighth 
dorsal. See spinal treatments. Nos. 43, 34. 

Tic douloureux is a neuralgia of one or more 
branches of the fifth nerve, and lesions are looked 
for in the upper dorsal and cervical regions. A 
misplaced atlas or axis is most frequently to blame 
for the condition. Treat as in Nos. 1, 3. Pay atten- 
tion to the upper back tissues, as in Nos. 34, 43. In 
many cases a thorough abdominal treatment will be 
of assistance. See Nos. 94 to 100. In all cases of 
neuralgia or of neuritis the muscles and nerves 
should be relaxed. 

In facial neuralgia, tic douloureux and brachial 
neuralgia a hot water bag may be applied to the 
back of the neck and the upper dorsal region. Tic 



Disease and Its Treatment 349 

douloureux has been helped locally by the appli- 
cation of the inner skin of a fresh egg, sprinkled 
with black pepper. Some medical writers in cases 
of tic douloureux recommend one one-hundredth of a 
grain of nytroglycerine until relief is obtained. 

PEDAL NEURALGIA. 
(Neuralgia of the Feet. Tarsalgia.) 

This is often caused by a broken-down arch of the 
foot. The patient should rest as much as pos- 
sible. Let the shoes have broad, thick soles. Some- 
times it is best to have a supporting arch, made 
of steel and covered with leather, for the instep. 
They may be found in many shoe stores. The 
foot should be manipulated. See Nos. 117, 118. 

ERYTHROMELALGIA. 
(Red Neuralgia of the Feet.) 

This is a disease of the feet, characterized by 
pain and extreme redness of the feet. In some cases 
there is so much swelling that the patient is un- 
able to walk. The condition is worse in warm 
weather. The disease is accompanied or generally 
followed by some disease of the spine or some 
severe nervous trouble. 

From the medical standpoint the cause is un- 
known, but is due to a disturbance of nerve function 
due to pressure, disturbing nerve impulses. 

The treatment should be directed to the removal 



350 Practice of Osteopathy 

of any lesions found in the spine. A thorough re- 
laxing treatment should be given in the lower dorsal 
and lumbar region. See Nos. 43, 36, 41, 48, 51, 52. 

Should the pelvis or either innominate bone be 
out of place, proper correction should be made. 
See lesions of the pelvis and innominates. Work 
on the tissues of the legs, as in Nos. 113, 116. Per- 
form circumduction and extension, as in Nos. 113, 
114. Manipulate the foot, as in Nos. 117, 118, 119. 
Put the muscles on a torsion, as in Nos. 121. 

Should there be any other disease it should re- 
ceive its proper treatment. Some of these cases 
are badly constipated. 

In some cases great relief is experienced by 
putting the foot in ice-cold water. Keep the feet 
elevated and rest as much as possible when the 
attack is severe. 

INTERCOSTAL NEURALGIA. 

(Pleurodynia. Muscular Rheumatism.) 

This affection is generally classed as muscular 
rheumatism. It causes intense pain, which is ag- 
gravated by the breathing. The ribs should be 
separated and lifted up as in Nos. 86, 82. 

Some of the hot applications should be applied 
as recommended in lumbago, which see. 



Disease and Its Treatment 351 

TORTICOLLIS. 

(Stiffneck.) 

The muscles of one side of the neck are very 
stiff and sensitive, frequently drawing the head 
to the affected side. Lesions of the neck should 
be removed. These are the direct cause of the dis- 
turbance by making pressure on the nerve. When 
this pressure is removed a permanent cure should 
be effected. Thoroughly relax all tissues of the 
neck. See Nos. 1, 3, 5, 9, 10, 11, 12, 13. Replace 
any vertebra which may be out of its proper posi- 
tion. Nos. 1, 3. Local hot applications as in lum- 
bago will be found to be helpful. 

MUSCULAR RHEUMATISM. 

This is a painful affection of the voluntary mus- 
cles in various parts of the body. The attacks fol- 
low exposure to cold, wet, and exposure especially 
after a severe bodily exertion. One attack renders 
others more liable. Some writers consider this dis- 
ease a form of neuralgia, rather than rheumatism. 
The varieties of this disease are often named from 
the portion of the body affected, as lumbago, tor- 
ticollis, pleurodynia, cephalodynia, etc., all of which 
see for treatment. 



352 Practice of Osteopathy 

LUMBAGO. 

This is a rigid, painful condition of the muscles 
in the lower part of the back. Stooping or turning 
the body or any sudden movement causes pain. It 
is caused by an affection of the lumbar vertebrae, 
causing an inflammation of nerves supplying the 
muscles of the back in this region. 

Treatment. The muscles should be gently re- 
laxed, as in Nos. 43, 44, 47, 48, 50, 52, 53, 57. The 
spine should be gently stretched and rotated, as in 
Nos. 58, 59, 60, 61. This is done for the purpose 
of taking the pressure off the nerves. Hot fomenta- 
tions should be used. See treatment of acute artic- 
ular rheumatism. Hot water bags may be applied, 
or sacks filled with hot salt or hops. A heav} piece 
of flannel may be applied and a warm flat iron may 
be used over it for a few minutes, literally ironing 
the back. This treatment is very efficient. Pressure 
is helpful. 

Acupuncture has been highly recommended. Take 
an ordinary bonnet needle, three or four inches 
long. Sterilize it and thrust it into the lumbar 
muscle at the seat of pain. Leave it there for 
five or ten minutes. The needle should be thorough- 
ly sterilized. 

The best treatment, though, is the osteopathic, 
as outlined first, the manipulation of the spine 
and spinal muscles and ligaments. Those who 
suffer from periodic attacks of the disease may be 
permanently cured in this manner. 



Disease and) Its Treatment - 353 

Long and successful experience in treating this 
disease has led me to believe that often we are wrong 
in ascribing the cause of this trouble to the poor 
alignment of the lumbar vertebrae. It is rather 
caused by poor circulation, that does not permit the 
venous blood properly to escape from the lumbar 
portion of the spinal cord which, in turn, overstimu- 
lates the spinal nerves and causes them to send too 
many nerve impulses. This makes the muscles 
which they supply over tense. 

In many cases I have treated there would be im- 
mediate relief and the patient could make very free 
movements without any discomfort, but in a few 
hours the trouble would appear and give as much 
pain as ever. One evening I was called to treat a 
very strong and muscular young man, who had been 
suffering wnth lumbago for several days, and had it 
so severely that he could hardly move in bed. After 
treating him about one half hour in the regular way 
I discovered that about the only relief I could give 
him was steady pressure on the spine while he was 
lying face downward. The bed was rather low and 
he was lying on the side, when I applied some weight 
with both knees, and upon his saying, " Doctor, I feel 
it going out," I applied my entire weight and walked 
with my knees for fully five minutes on the lumbar 
portion of his spine. I weighed then over 200 
pounds. But you must bear in mind that he was 
more than an ordinarily strong man. 

He immediately arose from his bed and dressed 
and insisted on my remaining for dinner. His folks 



354 



Practice of Osteopathy 



looked upon his appearing at the table much as they 
would had a miracle been performed. He came to 
the office for further treatment, next day. The 
treatment was then applied with the knees for about 
five minutes, and there was no further return of the 
trouble. 

This treatment inhibited nerve impulses and im- 
proved the circulation to the spinal cord. 



Disease and Its Treatment 355 



MENTAL DISORDERS. 
Insanity. 

Insanity is a mental disorder marked by delusions, 
illusions and hallucinations, by changes in character 
and habits, and by unreasonable actions and language. 
It is more or less permanent in character, but with- 
out loss of consciousness or will. 

There are many causes for some forms of insan- 
ity, which an Osteopath will fail to find. There are 
causes which his or any other form of treatment can 
not reach. But when the general treatment is given, 
paying particular attention to the cervical region, the 
patient will be benefited under Osteopathic treat- 
ment. Many cases of insanity are due to an accident 
of some kind in which the head or neck is involved. 
Many of these patients become mentally unbalanced 
at once, while others are affected gradually. The 
extent which Osteopathy will cover in this field of 
psycho-pathological conditions as a therapeutic agent 
is still unknown. Osteopaths are not given the op- 
portunity to get hold of such patients in large num- 
ber, but what experience they have had has been 
very gratifying. 

I have known patients who had become violently 
insane as the result of an accident. It was necessary 
for strong men to hold them while an Osteopathic 



356 Practice of Osteopathy 

treatment was being administered. After the treat- 
ment they would fall asleep. After waking they 
were entirely rational. A prominent Osteopath, be- 
fore studying the science, was confined in an insane 
asylum in Iowa. In some way he became possessed 
with the idea that if he could get to an Osteopath he 
would be cured. He escaped, went several hundred 
miles in search of the treatment, and was entirely 
cured, after which he became a splendid Osteopath 
and enjoys a large practice. 

My experience with insanity has been limited, but 
the treatment has proved very quieting and benefi- 
cial, even when the case was of long standing. 

We may expect to find serious trouble in the neck, 
in vertebrae, ligaments and muscles. The deeper 
muscles here are very strong, and when they become 
tense as a result of some nerve irritation are often 
abnormally tense, and thus act as obstructions to 
various vital fluids. For the treatment read care- 
fully all about the various treatments of the neck. 
The ribs and dorsal vertebrae should be carefully 
examined and treated. 

In recent cases we may expect the best of results. 
In other cases look for considerable improvement. 



Disease and Its Treatment 357 

ST. VITUS' DANCE. 
(Chorea.) 

Chorea is a disease characterized by an incoordi- 
nate movement and twitching of the muscles either 
local or general. There is often some slight psychic- 
al disturbance and great liability to endocardi- 
tis. About three-fourths of the cases are girls be- 
tween the ages of five and seventeen. In many 
cases the disease is hereditary. Among the excit- 
ing causes may be mentioned fright, worry, grief, 
modern forced methods of education, eye diseases 
or weakness. 

The Osteopath expects to find some anatomical 
lesions as a predisposing cause, the correction of 
which leads to the cure of the disease. 

The symptoms manifested in chorea have such a 
wide range and are so varied in character that for 
convenience they are classified under three divi- 
sions in which the mild, severe and most severe or 
extreme cases are described. The disease generally 
attacks a hand with a jerky motion, then attacks 
the face, and later the legs. In the mild forms only 
the hand or hands and face are attacked. The child 
is restless, cries easily and often. There is head- 
ache and pains in the limbs. The patient loses the 
temper frequently and is easily frightened at night. 

In the severe forms the trouble becomes more 
general in character. The speech is affected and 
the patient may be unable to dress and attend to 



358 Practice of Osteopathy 

ordinary duties. The extreme form may develop 
into insanity. 

Treatment. The disease yields most readily to 
osteopathic treatment. The lesions are usually in 
the upper dorsal and cervical regions. Muscular 
tissues are found in a tightened condition. Of 
course the first thing for the Osteopath to do as 
soon as possible is to remove the lesion. In addi- 
tion, a thorough general treatment is indicated. 
See general treatment. Special attention should 
be given to the groups of muscles most affected. 
They should be thoroughly massaged, and the limb 
or arm, as the case may be, thoroughly manipulated. 
See Nos. 113, 114, 131. Treatment should be given 
daily until the patient is better, then three times per 
week and later twice per week. The cases ordi- 
narily call for a long course of treatment. 

Make sure that there are no intestinal worms, 
eye strain, sexual disorders, cause for worry, mental 
strain, overwork or severe muscular exertion. At- 
tention should be given to the heart and bowels. 
See constipation. A soap suds enema may be used 
when necessary. 

The Diet. Sweets and starches are better left 
alone, otherwise the patients may be encouraged to 
take as much nourishing food as they can digest. 
Meat, eggs, oysters, fish with plenty of green vege- 
tables are recommended. 

A warm bath on retiring and a cool sponge bath 
with a brisk rub on rising will be found to be bene- 
ficial. 



Disease and Its Treatment 359 

EPILEPSY. 

This disease is an affection of the nervous system, 
marked by attacks of unconsciousness occurring at 
irregular intervals. There may be convulsions. If 
they are severe general convulsions it is called 
Grand Mai. Localized convulsions, without loss 
of consciousness, is known as epileptiform, or corti- 
cal, or Jacksonian epilepsy. 

Cause. Osteopaths find various spinal and rib 
lesions, which when removed have cured a fair pro- 
portion of cases. Syphilis and alcoholism, on the 
part of parents, are believed to be a prolific cause 
of this disease. In some cases it has been caused 
by worms, an adherent prepuce, foreign bodies 
in the ear or nose, or some other local affection 
setting up reflex influences. 

Symptoms. Grand Mai. In most cases there is 
an aura or subjective symptom in some part of the 
body which warns the patient of the impending 
attack. This aura may be a peculiar sensation in 
the hand or foot or heart or stomach. With others 
it seems to be a flash of light or some form of per- 
verted appetite. The patient often utters a cry or 
yell, the epileptic cry, and falls where he is as if 
shot. The first spasm, which lasts but a few se- 
conds, is followed by convulsions, during which 
the patient may froth at the mouth. He may al- 
so lose control of the bladder and bowels. From 
this he passes into a sleep when he is in a relaxed 
condition. On awakening he complains of fatigue. 



360 Practice of Osteopathy 

Petit Mai. The patient becomes unconscious for 
but a moment. The expression becomes blank and 
the face pale. A person talking to him will be 
conscious of the condition, but the patient is some- 
times not. The patient does not fall and frequently 
picks up the thread of the conversation and con- 
tinues it. 

Jacksonian Epilepsy. A spasm that is only local 
and affects a hand or arm or a single group of mus- 
cles. There is generally an aura, but the con- 
ciousness is preserved. 

Epilepsy may be distinguished from hysteria by 
the sudden onset with a cry, without apparant cause, 
the rigidity followed by convulsions and biting of 
the tongue. There may be defecation or micturi- 
tion, but no talking. 

Hysteria comes on gradually, with emotions pre- 
ceding. If there is a cry it is during the attack. 
They bite other things than the tongue and talk 
frequently, but there is no micturition or defecation. 
The attack may be terminated by the use of water. 

Treatment. The best osteopathic authorities have 
found various lesions from the neck to the lumbar 
region, including rib lesions, which have been the 
cause of the disease. The neck lesions are the most 
frequent, and we should make diligent search for 
them for the cause of the disease. At the time of 
the attack we need not expect to do much for the 
case. Strong treatment and pressure at the base of 
the skull, suboccipital fossae, helps some cases (see 
No. 7B), while others are helped by treatment over 



Disease and Its Treatment 361 

the solar plexus. See No. 100. Give a thorough 
abdominal treatment for the purpose of calling the 
blood away from the head. A thorough general 
treatment should be given at least three times per 
week. Lesions wherever found should be removed. 
See general treatment. Especial attention should 
be given to the neck treatment. See Nos. 1, 3, 5, 
9, 10, 11, 13. Have the patient open the mouth 
against resistance. See No. 8. The clavicles should 
be elevated and the first rib depressed. See Nos. 72, 
73, 75, 80. 

The cervical sympathetic nerves should be treated. 
See No. 7C. The bowels and stomach should re- 
ceive attention. See stomach. Stomach and in- 
testinal indigestion may act as a cause by allowing 
the food to ferment and poison the system, causing 
autointoxication. The diet should be light and nu- 
tritious and easily digested. Indigestible food should 
be forbidden. See dyspepsia. 

In children adenoid growths should be looked 
for, and in a male child if phimosis exists it may be 
necessary to perform circumcision, or at least to 
break up adhesions. Should there be evidences of 
digestive disturbances with constipation treat as 
such. 

The Medical Treatment. With children 25 to 50 
grains of sodium bromide are given per day, giving 
the larger part of it a short time before the seizure 
generally occurs. The dose is alwaj^s largely di- 
luted with water, say a glass three-fourths full. 
Should there be chronic constipation a dose of 



362 Practice of Osteopathy 

calomel is recommended once per week, followed in 
a few hours by a dose of salts, an enema of salt 
water, a tablespoonful of salt to a quart of water, 
to be given twice per week. An adult may take a 
drachm to a drachm and a half of sodium bromide 
daily, sometimes at a single dose. This drug is 
best taken under the direction of a physician, as it 
must be taken a long time and the system must be 
saturated with it, certain diagnostic symptoms of 
which must be watched for and kept at that point. 
By all means the osteopathic treatment as out- 
lined above should be given a thorough trial first. 

NEURASTHENIA. 
(Nerve Exhaustion.) 

Neurasthenia is a nerve disorder, in which there 
is nervous and bodily weakness. This is accom- 
panied by irritability. The disease is very common 
in America. It is due to hereditary weakness, ex- 
cessive expenditure of nerve force, and in most 
cases anatomical misplacements which impair nerves 
by pressure direct and interference with proper nu- 
trition. Other causes are manifest, as, living at too 
rapid a rate, overwork, overstudy, worry, mental 
depression, the use of tobacco, alcohol, sexual over- 
indulgence, indigestion, gout, rheumatism, la grippe 
and malaria. 

The symptoms are many and varied and differ in 
different individuals. Headache is common and 
may be either at the base of the skull, in the fore- 



Disease and Its Treatment 363 

head or in the top of the head. Some complain of 
a constricting band about the head. The memory 
is poor, the patient is afraid of places and things, 
and is irritable. There is pain in different parts of 
the spine. The limbs feel weak. The patient com- 
plains of hot flashes and has cold sensations. The 
flesh turns blue in spots. There may be constipa- 
tion, indigestion, dyspepsia, palpitation of the heart 
and various affections of the eyes and ears. 

Treatment. All lesions should be sought for and 
removed. A gentle general treatment may be given 
each day for awhile. Then three times per week, 
reducing to once per week, as the patient grows bet- 
ter. See general treatment. The treatment must 
be a searching one and complete. Warm baths 
twice per week at night. A cold sponge bath fol- 
lowed by brisk rubbing each morning will prove 
of benefit. Rest, with moderate exercise and good 
food, is essential. The treatment must be kept up 
for a long time. 

SCIATICA. 
(Sciatic Rheumatism.) 

This disease is an inflammation or neuritis of the 
sciatic nerve, or of the nerve cords which form the 
sciatic nerve. In some cases it may be a neuralgia. 

The pain frequently comes on gradually, but it 
may be sudden and very severe. At first it may be 
a dull pain in the back of the thigh, but later it may 
spread down the limb even to the bottom of the foot. 
In some cases it is complicated with lumbago. 



364 Practice of Osteopathy 

The osteopathic treatment is directed to the re- 
moval of any lesions that may be present in the low- 
er part of the back. The tissues are fully relaxed, as 
in lumbago. The work is carried down carefully 
over the affected nerve and limb, all tissues being 
thoroughly relaxed. See lumbago and Nos. 113, 51, 
52. The pyriformis muscle, which lies across the 
trunk of the nerve, is frequently contracted and 
causes pressure on the nerve. This may be stretched 
by strong internal circumduction of the limb. See 
No. 114. 

The nerve may be stretched carefully, as in No. 
115. Careful treatment followed up in this manner 
will remove all irritation and result in a permanent 
cure. 

Heat will prove beneficial, used along the course 
of the nerve by the application of the hot water 
bag. When the pain is severe an ice bag applied to 
the spine in the lumbar region will prove helpful. 

HYSTERIA. 

Hysteria is a functional disease of the nervous sys- 
tem. It is characterized by loss of self control, and 
accompanied by disorders of all or of a part of the 
bodily functions. It occurs most frequently in wom- 
en and children. 

Osteopaths look for the primary cause in some 
bony lesion of the spine, or ribs, or pelvic bones, 
or some malposition of some organ. The secondary 
causes may be emotional disturbances, mental or 



Disease and Its Treatment 365 

physical strains, domestic troubles, masturbation, 
sexual excesses, ovarian or uterine diseases. 

The symptoms cannot be said to follow any fixed 
rule, as a hysterical patient can imitate any symptom 
or diseased condition. The patient frequently feels 
a ball in the throat, which seems to come from be- 
low and produces a choking sensation. This is re- 
ferred to in medical literature as " globus hysteri- 
cus." There may be convulsions, after which the 
patient seems to be bloated with gas, and passes 
large quantities of urine. The voice is often lost 
and the various forms of paralysis are often simu- 
lated. The joints may become stiff and there may be 
spasms. Intense pain may develop in the head, 
spine, abdomen, or ovarian region and in the breast. 
There may be rapid and difficult breathing, vomit- 
ing and nausea. The temperature is nearly always 
normal. 

Treatment. Particular attention should be given 
to the lower ribs. They are often found displaced, 
generally downward. See Nos. 90, 91, 92, 93. The 
intestines should be lifted up. See Nos. 96, 97. A 
general relaxing treatment should be given. See gen- 
eral treatment. Remove any lesions found in the 
spine or ribs. A change of enviroment may be 
helpful in many cases. The patient should be dealt 
with kindly, yet firmly. If possible, get the patient 
to exercise self control. A warm tub bath twice per 
week and a cold sponge bath every morning, fol- 
lowed by a brisk rub, will prove helpful. Out of 
door exercise should be taken each day. If a child, 



366 Practice of Osteopathy 

avoid overstudy under competitive methods. Avoid 
over indulgence of every nature. Let the diet be 
plain, but there should be plenty of nutriment. 

OCCUPATION NEUROSIS. 

Telegrapher's cramp or telegrapher's paralysis, 
writer's cramp, or paralysis, pianist's paralysis, milk- 
er's paralysis, cigar maker's paralysis, are all due to 
the over-use of the nerves through the over-use of 
certain groups of muscles used in some occupations. 

Osteopaths find, in most cases, some obstruction 
to the nerve force, through pressure, which acts as 
a primary cause of the difficulty. Sometimes the 
first, second and third ribs are too close together. 
Frequently the cervical and upper dorsal vertebrae 
are affected. In some cases the clavicle is too close 
to the first rib. 

The very worst of these cases make good progress 
under osteopathic treatment. Remove the lesion 
in every case. All tissues in the neck, shoulder and 
arm should be relaxed as in a general treatment, 
which see. Stretch the elbow and shoulder joints. 
See Nos. 129, 130, 131. Give the arms thorough 
treatment. See treatment for arms, No. 131. See 
treatment for ribs and clavicles. Sometimes rest is 
necessary. The clothing should be loose. Let noth- 
ing interfere with the circulation. 



Disease and Its Treatment 367 

PARALYSIS AGITANS. 
(Parkinson's Disease: Shaking Palsy.) 

A chronic nervous disease, characterized by tre- 
mor or rapid alternate contraction and relaxation of 
the muscles, a peculiar gait and speech and progress- 
ive loss of power. 

The causes are found in spinal and upper rib 
lesions, v^hich weaken the nervous system, rheu- 
matism, rheumatoid arthritis, exposure, fright and 
mental anxiety. It is a disease that affects men 
more than women and is more frequently found be- 
tween the ages of forty and sixty. 

The first appearance is in a muscular tremor, gen- 
erally of the forearm. The thumb and forefinger are 
approximated and have been spoken of as " the act 
of making a pill." The head is not often involved, 
but when it is the motion is a nodding one. When 
the patient is sleeping the tremors cease, and some- 
times when the patient does something in which he 
forces the affected parts to act, the tremors are 
quiet but are resumed immediately when the act is 
completed. 

In walking, the head is bent forward, the steps 
are short and hurried, gradually, in some cases, be- 
coming faster until it seems as if the patient was 
about to fall. In severe cases he must stop and hold 
to something before getting a fresh start. 

The face has a peculiar aspect, spoken of as " the 
mask-like expression," due to the set condition of 
the facial muscles. Ordinarily the disease has a 



368 Practice of Osteopathy 

long, slow course and the patient generally dies of 
some other disease. One may not expect help of 
the regular medical treatment. The leading works 
on the subject offer no hope of a cure. 

Treatment. The neck and the upper part of the 
back and the ribs should have a careful examination, 
and all lesions found should be carefully removed. 
See treatment of neck, spine, ribs and clavicles. 

This disease has conditions that require a gen- 
eral osteopathic treatment. See general treatment. 
In addition to the removal of all departures from the 
normal which are found, the neck, shoulders and 
spinal tissues should be thoroughly relaxed. See 
N'os. 1, 5, 8B, 34, 43, 53. Give special attention to 
the treatment of the kidneys, liver and bowels. 

Salt baths may be given twice per week. The pa- 
tient should take exercise, but should stop before 
becoming very tired. 

SPASTIC PARAPLEGIA. 

This is a disease of the spinal cord, in which there 
is a loss of muscular power. There are exaggerated 
reflexes, a peculiar gait and precipitate micturition. 

The disease is more apt to occur in a family with 
a nervous history. It is frequently brought on 
through exposure, accidents resulting in blows, falls, 
etc. It may also follow some of the acute diseases. 

In most cases the onset of this disease is slow. 
Weakness of the lower limbs is a symptom. The 
patient complains of feeling tired and has increasing 



Disease and Its Treatment 369 

difficulty in walking. The muscles frequently be- 
come rigid. This rigidity assumes the nature of a 
passing spasm. When the disease is further ad- 
vanced the legs grow weaker and stiffen When the 
patient walks the toes scrape the ground. The 
Osteopath looks for lesions along the spine, and ex- 
amines the ribs to see that they are in a normal posi- 
tion and treats as in locomotor ataxia, which see. 

LOCOMOTOR ATAXIA. 

This is a nervous disease, caused by a hardening 
of the posterior columns of the spinal cord. The 
disease is characterized by loss of coordination of 
the muscles. When the patient stands with the 
heels close together, with the eyes shut, there is a 
tendency to fall (Romberg's symptom). With the 
arms stretched from the sides the patient is unable 
to approximate the forefingers with the eyes closed. 
The walking is peculiar. The limbs are lifted high- 
er than necessary and brought down with vigor. 
There is a slight staggering and difficulty in walk- 
ing at night. When lying, the patient finds difficulty 
in bringing the heel of one foot to the knee of the 
other leg. The muscles have a tendency to waste. 

The disease is frequently a long time in develop- 
ing, and may be in progress a number of years, with 
but little notice of the patient. There are occasional 
pains in the legs, slight changes in vision, often an 
impairment in sexual power, sometimes, though 
rarely, an increase. Later the pain in the limbs be- 



370 Practice of Osteopathy 

comes more pronounced. There is a boring sensa- 
tion, coming and going with great rapidity, termed 
lightning pains. The pupils fail to contract to light. 
To determine this symptom, darken the room for 
awhile. Then hold a lighted match before the pa- 
tient's eye. The pupil, if it contracts at all, does 
so very slowly. This is known as the Argyll-Rob- 
ertson pupil. There is loss of knee jerk. To de- 
termine this symptom, have the patient sit on the 
side of the table with the feet hanging, not touch- 
ing the floor. Strike the tendon, just below the pa- 
tella, a sharp blow with the edge of the palm of 
the hand. If in normal condition the foot will kick 
out. If there is probably locomotor ataxia it will re- 
main stationary. 

Diagnosis. The Argyll-Robertson pupil, Rom- 
berg's sign, lightning pains and absence of knee jerk 
are enough of the symptoms to determine that the 
patient has locomotor ataxia. 

Prognosis. While but little can be promised as 
far as a cure is concerned, there are few if any cases 
that will not be helped and many may be helped to 
a large extent by osteopathic treatment. Of course, 
the earlier the treatment is begun the better. In a 
great many cases the progress has been checked. 
Control of bladder and rectum is regained, and many 
cases which had lost the power of walking regained 
this function under treatment. 

Treatment. This disease requires a general spinal 
treatment, with special attention to all specific 
lesions of the spine and ribs. See general treat- 



Disease and Its Treatment 371 

ment. The lower limbs should also receive careful 
attention and manipulation. Care must be taken 
not to fracture the long bones, as in this disease 
there is a predisposition to fracture. We must not 
forget thorough abdominal work. See Nos. 94 to 
103. Special attention should be given to this. 
Tone up the solar plexus. The regular treatment 
should be given three times per week. The author 
would recommend as a home treatment, in addition 
to the above, each day the application of a long ice 
bag to the spine for fifteen minutes, followed by a 
hot water bag for fifteen minutes, then the ice again, 
followed by the hot water, in all an hour's treat- 
ment. This will serve to promote the circulation in 
the spinal cord. The application of the ice bag 
alone will help to relieve the lightning pains. It is 
well for the patient to exercise, but he must avoid 
overexertion. 

The ataxia may be overcome in part by the con- 
tinued practicing of fine movements. Some of 
these may be executed by the patient with the limbs 
as he lies on his back. 

SICK HEADACHE. 
(Migraine, Hemicrania, Cephalgia.) 

Migraine is an intense headache, occurring fre- 
quently, with or without disturbances of vision or of 
nausea. Medical writers as a general rule claim 
that no lesions h^ve been discovered, but Osteopaths 
frequently find neck lesions, also upper dorsal 



372 Practice of Osteopathy 

lesions, the removal of which has resulted in cures. 

The patient can tell for some time previous when 
an attack is to be expected, by the sensations and 
symptoms peculiar to each given case. The pain 
at the beginning of an attack is on both sides of 
the head, but after awhile it localizes on one side. 
With some patients the attack localizes on one side 
at one time ; at the next time it localizes on the other 
side. Some cases continue from childhood to old 
age. 

Most of the lesions have been found in the neck 
and upper dorsal region, though some have been 
found in the lower dorsal and lumbar regions. 
Stomach troubles, uterine misplacements, eye strain, 
and tumors are sometimes responsible. These causes 
must have special treatment. 

Treatment. The neck must be thoroughly ma- 
nipulated. See Nos. 1, 3, 5, 7, 9, 10, 11, 13. All 
spinal muscles and tissues should be relaxed. Nos. 
4, 43, 48, 53. The abdomen should receive a deep 
inhibitive treatment. Nos. 94 to 99. Give heavy 
pressure over the solar plexus. No. 100. Misplaced 
vertebrae and ribs should be corrected. Tissues over 
the nerves in the face should be relaxed. Nos. 14, 
20, 21. Work vigorously and deeply with thumb and 
finger on a line straight over the head, from the 
nose to the base of the skull at the back of the neck. 
See No. 16. Give heavy pressure on the skull. No. 
15. Give heavy deep treatment at the base of the 
skull, on each side of the spine. This may be tem- 
porarily painful, but will be effective. No. 7B. 



Disease and Its Treatment 373 

Pressure may be given in the upper dorsal region. 
No. 67. The clavicles should be raised. Nos. 72, 73. 
The treatment should be given deliberately, and is 
probably the longest that the Osteopath gives. Great 
relief should be given during the first treatment. 
A very general treatment will be helpful. See gen- 
eral treatment. Give particular attention to the 
stomach and bowels. The patient should avoid over- 
exertion, as becoming tired acts as an exciting 
cause. A hot mustard foot-bath, heat at the base of 
the skull, and an ice bag on the forehead is often 
helpful. Should there be nausea, use the ice bag on 
the spine from the fourth dorsal down to the first 
lumbar vertebra. Some patients are helped by a 
cup of strong, clear coffee. 

The drug treatment for this condition is very 
unsatisfactory. Headache powders, pills and the 
various pain killers are dangerous. The extract of 
cannabis indica is sometimes given for a long time, 
two or three times per day, in doses of a fourth to a 
third of a grain in hope of curing the condition. At 
the time of the attack the following pills are some- 
times given : 

Acetanilid 20 grains. 

Codein Sulphate 5 grains. 

Camphor monobromate 5 grains. 

Make of this ten pills and take one every two hours 
until relieved. The heart action should be watched 
when using these pills. Menthol pencils are used 
locally for the purpose of relieving the pain. Rub 
them over the seat of the pain. 



374 Practice of Osteopathy 

TUMORS. 

Fibroid Tumors, Benign Tumors, Malignant 
Tumors.) 

Tumors of every nature have been removed by 
osteopathic treatment. In addition to those above, 
many uterine tumors, as well as ovarian and cystic 
tumors, fatty tumors, abdominal and intestinal tu- 
n.ors, even those supposed to be of cancerous nature, 
have been removed under the treatment. Especially 
good results have been secured with tumors of the 
breast. 

The cause for most tumors will be founcl' in some 
spinal or other bony lesion, or in some misplaced 
soft tissue which interferes with the nerve supply 
or with the circulation, especially of the venous 
and lymphatic drainage of the part affected. When 
the blood or lymph at any given point is obstructed, 
whether it be from a defective nerve supply or by 
direct pressure of some bone or organ, that blood or 
lymph often causes an abnormal growth or tumor. 

Abdominal Tumors. In case the tumor is located 
in the abdomen it will be well to carefully examine 
the spine for any spinal lesions, and remove them, 
using Nos. 34, 43, 44, 36, 37, 41. The ribs must be 
carefully looked after and any misplaced ones must 
be corrected. See Nos. 81 to 93. The abdomen 
must be carefully treated, as in Nos. 94 to 100. 
Should there be enteroptosis (which see), that must 
be treated according to directions. In general, tumors 
should not be worked directly-over or massaged, 



Disease and Its Treatment 375 

but they may be lifted up and their position carefully 
shifted and adjoining tissues may be manipulated. 
A general treatment is often advisable for the entire 
circulation and for the nervous system. Treat about 
three times per week. When better treat twice and 
once per week. The treatment in the main is di- 
rected to restore the proper circulation. In some 
cases the treatment must be continued for some 
time, but often the improvement is noted soon. 

Uterine Tumors. Intrauterine, extrauterine or in- 
terstitial tumors are frequently removed by osteo- 
pathic treatment. The intrauterine tumor is fre- 
quently pedunculated, and at the menstrual period 
causes great pain, because the uterus at that time 
tries to expel it. The interstitial is a part of the 
enlarged wall and the extrauterine is on the outside 
of the wall and attached to it. These tumors are 
frequently caused by a misplaced uterus. This cor- 
rection should be made by a well-qualified practi- 
tioner. Very frequently there is a luxated pelvis, or 
innominate bone, or a misplaced vertebra which, 
when corrected, restores the proper circulation and 
results in the removal of the tumor. In addition to 
the local corrective work necessary the spine and in- 
nominates may be treated. See Nos. 43, 51, 52, 57, 
104 to 112. In addition to the above a general treat- 
ment, which see, will be found very beneficial as the 
patient is generally nervous. 

Ovarian Tumors will require a careful examina- 
tion of the lower spine and the removal of all lesions 
found, and the pelvis should be looked after and 



376 Practice of Osteopathy 

treated in the same careful manner. See treatment 
for uterine tumors. The abdomen should be care- 
fully treated as in Nos. 94 to 100. Lift up the tu- 
mor and carefully manipulate the tissues about it, 
but do not work directly over it. 

Tumors and Nodules of the Breast. These are 
often caused by a misplaced rib or clavicle. See 
treatment for clavicles. Nos. 72, 73. Examine the 
ribs carefully, look for twisted ribs and ribs that 
are luxated in such a manner as to be too close to- 
gether, and treat as directed under treatment for 
ribs. Lift up the ribs. See Nos. 81, 82, 86. Give 
the general treatment, which see. Many operations 
may be avoided in this way. 

DISEASES OF THE EYE. 

Impaired vision, weak eyes, pterygium, granu- 
lated lids, strabismus, atrophy of the optic nerve, 
blindness, cataract, diplopia, conjunctivitis, glau- 
coma, closed tear duct, astigmatism, keratitis, ptosis 
or drooping lids. All of these diseases of the eye are 
frequently cured osteopathically. The lesions are 
generally found in the cervical and upper dorsal re- 
gions. These lesions interfere with both the blood 
and nerve supply. 

Treatment. The treatment would call for a thor- 
ough relaxation of all neck tissues. See Nos. 1, 3, 
.5, 7B, 9-11, 13. Relax all tissues in the upper dor- 
sal region. See Nos. 34, 43, 53. The fifth nerve 
may be treated, as in No. 21. Pay attention to the 



Disease and Its Treatment 377 

clavicles and first ribs. Nos. 73, 72, 75 to 80. Open 
mouth against resistance. See treatment of the ears 
and No. 8. With the lids closed considerable work 
may be done about the eye and in the bony cavity. 
In some cases, as in cataract, we may percuss over 
the eyeball, as in Nos. 20, 22, 25, 26. 

All lesions in the cervical and upper dorsal verte- 
brae and in the corresponding ribs should be re- 
moved. Should it be advisable to use an antiseptic 
solution a four per cent boric acid solution may be 
used, or a bichloride of mercury solution, 1 to 5,000, 
may be used. 

Conjunctivitis and trachoma, in addition to the 
osteopathic treatment, as outlined above, should be 
kept very clean with a boric acid solution. Should 
the case be very severe and there be evidence of in- 
fection it should each day receive an application of 
a silver nitrate solution (one per cent). Hot appli- 
cations should be used, cloths wrung out of hot 
water and applied as can be borne. In cases of 
keratitis, there is great pain, an aversion to the 
light, considerable inflammation, redness. In addi- 
tion to the osteopathic treatment, use hot water ap- 
plications. Keep the eyes clean with a boric acid 
solution, four per cent. A thorough general treat- 
ment is indicated each day. See general treatment. 

DISEASES OF THE EAR. 

In cases of deafness the neck and back treatment 
are similar to the treatment in cases of diseases of 
the eye, which see. 



378 Practice of Osteopathy 

In addition to the above, use peroxide of hydrogen 
to loosen wax, after which an ear syringe should be 
used to cleanse the external ear of any discharges 
or secretions which may have remained in it. The 
mouth of the patient should be opened against re- 
sistance. The operator stands at the head of the 
reclining patient, and with both hands under the 
chin of the patient who furnishes the resistance. 
It should be opened slowly against this two or three 
times. This greatly assists the circulation to both 
ears and eyes. 

In case of earache, lie with the ear on a hot 
water bag. If the patient is an infant, breathe into 
the ear. In some cases of earache a glass ear tube 
with a recurrent flow is used, with the water at a 
temperature of about 100 degrees. 

JOINT AFFECTIONS. 
(Deformities. Slight Dislocations. Bow Legs.) 

The various affections of joints have been very 
successfully treated by Osteopathy. In many cases 
a slight dislocation may be the real first cause of 
the trouble. In other cases the cause may have been 
rheumatism. Still other cases may be due to in- 
sufficient bone nourishment in youth. 

In all such cases it is best to begin at the origin 
of the nerves supplying the joint in question. If the 
joint is below the waist the nerve supply is looked 
for in the lower dorsal and lumbar regions of the 
spine. If the trouble is in the arms or shoulder we 



Disease and Its Treatment 379 

treat in the neck and as low down as the third and 
fourth dorsal vertebrae. Treat all the tissues down 
to the affected joint from its nerve supply. Work 
to secure a good nerve and blood supply as well. 

Don't treat the joint too severely at first. Work 
to relax the ligaments of the joint. A gentle treat- 
ment is more successful in relaxing ligaments than 
a severe treatment. The joint may be stretched, 
rotated, bent and manipulated in all possible ways. 
Should there be a perfectly immovable joint it may 
be necessary to break it up under an anesthetic, 
but if there is some movement in the joint it is 
caused by a tightened condition of the ligaments 
rather than a bony ankylosis. Such a joint may be 
greatly improved, and in many cases complete res- 
toration of function may be accomplished. 

Slight dislocations may be manipulated and grad- 
ually forced back into their normal position. Of 
course, if the condition is one of long standing it 
may take some time. In recent cases the work may 
be frequently accomplished in a few minutes. 

Bow Legs. This condition is often the result of 
weakness, sometimes rickets may cause the trou- 
ble. The case should be taken in hand early. Such 
cases do not get better of themselves. The spine 
should be treated as in Nos. 34, 43, 48, 50, 51, 52. 
The joint at the knee should be well manipulated. 
Give particular attention to the outside ligaments. 
One mother has the satisfaction of having a son 
with perfectly straight limbs who was badly de- 
formed in childhood. The good result came as a 



380 Practice of Osteopathy 

result of her own efforts patiently and consistently 
followed for some months. She rubbed the knees 
and especially the outside ligaments with salt water. 
She gave the treatment every night. This was be- 
fore Osteopathy was known in her State. She ex- 
erted pressure to straighten the limbs at the same 
time. 

Where the bend is just above the ankles the treat- 
ment in the back should be given as above. Thor- 
oughly manipulate the limbs. Use pressure to 
straighten them daily. See treatment of limbs. 

ARTIFICIAL RESPIRATION. 
(Sylvester's Method.) 

The patient is placed on his back, as in Fig. 106. 
It will be well to have the lower part of the body 
raised. The operator takes the arms near the elbow, 
as in the figure, and draws them forcibly outward 
and upward, where he holds them for two seconds to 
permit the air to enter the lungs, then the arms are 
brought down and pressed with considerable force 
against the sides of the chest for two seconds. 
These movements are made fifteen times per minute. 
See Figs. 106 and 107. It may be necessary in some 
cases to keep up the work for thirty minutes or 
more. 



Disease and Its Treatment 381 



KUATSU AND SPONDYLOTHERAPY. 

The Japanese have employed kuatsu in connection 
with jiujitsu for many centuries, as a method of 
resuscitation when a person was " knocked out " by 
the use of jiujitsu. In restoring a person to con- 
sciousness with kuatsu the patient is placed in the 
prone position and the operator strikes with his 
wrist on the seventh cervical vertebra a series of 
severe blows with regularity, the same as if a car- 
penter were striking blows with a hammer. See Fig. 
109. 

They now use it for persons who have suffered 
from sunstroke or drowning. It has been employed 
in this country, in a modified form, for the same pur- 
pose and for increasing the heart's action in emer- 
gencies. There has also been built up a system of 
treatment, based on kuatsu and a few of the prin- 
ciples of Osteopathy, for which a few claim consid- 
erable merit. Spondylotherapy claims to perform 
cures by percussing over certain areas of the spine 
in different diseases. This would appear to an Os- 
teopath to be spinal stimulation. But it would fail 
to remove any definite lesions which were the original 
cause of the disease, and the effects would be only 
temporary. 

The first effect of an Osteopathic lesion is over- 



382 Practice of Osteopathy 

stimulation of the organ that later becomes diseased. 
The organ overworks itself and soon becomes a vic- 
tim of this overwork. The lesion leads to a stimula- 
tion which finally becomes an irritation and the 
organ becomes diseased. After this stimulation the 
nerve fails to perform its function and more stimu- 
lation would only further weaken the nerve. It 
might be of some value in an emergency, but I fail 
to see its value in a chronic case. Osteopathy re- 
moves the lesion and restores the nerves, and thus 
the organs, to normal functioning. 



Disease andi Its Treatment 383 



FLAT FOOT. 

Weak Arches, Broken Down Arches. 

This trouble is due to general muscular weakness, 
to heavy strains, to lesions in the lower part of the 
back or innominate bones, which cause faulty atti- 
tudes, thereby straining supporting ligaments and in- 
terfering with the proper nourishment of the foot. 
Poorly-fitting shoes may be a causative factor. 

When the arches begin to break down the pain is 
often ascribed to a sprain or rheumatism. Improper 
treatment is applied and when the patient is heavy 
the trouble becomes worse quite rapidly. There is 
pain along the inside of the foot. There may be 
pain in the heel; also the calf of the leg. This pain 
may extend to the knee. The circulation becomes 
poor, with all the attendant symptoms, numbness, 
cold and, at times, perspiration. The pain may be 
out of all proportion to the deformity and there may 
be considerable deformity with very little pain. The 
foot grows more deformed, becoming flat and rigid. 

The treatment should be applied in such a manner 
as to secure pliability of the foot with the utmost 
freedom of motion. See paragraph 118, also Fig. 
93. Several weeks will be necessary to accomplish 
this. In the meantime have the patient wear a shoe 
with low, flat heels and broad toes. When walking 



384 



Practice of Osteopathy 



it will be well for him to place most of his weight on 
the outside of the foot. The inside of the shoe sole 
may be built up a little. Careful exercise may be 
carried on with benefit, but it should be carried only 
to the point of fatigue. Walking with toes turned 
slightly in and upon tiptoes will be helpful. In some 
cases after a certain amount of pliability is secured 
a cast may be necessary. Braces may help, but the 
difficulty with them is they are hard to fit. The use 
of adhesive strips in holding up the arch after it has 
been placed into something like normal position is 
advocated by some, and in many cases the treatment 
is successful. A lono" course of treatment is re- 
quired. 



Disease and) Its Treatment 385 



CRAMPS IN THE LEGS. 

Many persons are affected with cramps in the 
legs, which prove very painful. They most fre- 
quently occur in the calf of the leg and attack a 
patient after retiring for the night. The cause of 
the trouble is too many nerve impulses going to the 
muscles of the leg. Overexertion in walking or 
running, or any .occupation that would unduly ex- 
cite the lumbar segment of the spinal cord, might 
result in this trouble. When we get too warm, by 
having too much cover in bed, contractions of the 
calf muscles may result. Many have found that by 
stepping upon the floor they obtained relief. This 
stretched the muscles, as the Osteopath does, as 
shown in Fig. 90A. At the same time he inhibits 
the nerves of the lumbar region, as is shown in Fig. 
32. 

An easier way, and one that will be just as ef- 
fective, is to place a bag of ice or very cold water 
on the lumbar region of the spine. This will give 
instant relief. 



386 Practice of Osteopathy 



DISORDERED SWEAT GLANDS. 

This trouble is characterized by perspiration that 
is excessive or absent, fetid or accompanied by small 
vesicles upon the skin, accompanied by much sweat- 
ing. The scientific names for this disturbance, in 
the order given above, are hyperidrosis, anhidrosis, 
bromidrosis and sudamina. 

This trouble is caused by impairment of the nerve 
supply to the sweat glands, and as it is not certainly 
known where these centers may be found we give a 
thorough general treatment about twice per week. 
The founder of Osteopathy, Dr. A. T. Still, recom- 
mends that the facia all over the spine be thoroughly 
loosened, much as would be indicated in Figs. 48, 50 
and 51. See the pictures. In cases of unilateral 
sweating pay particular attention to loosening the 
structures of the neck. See neck treatment. The 
above treatment is recommended in cases of sweat- 
ing of the feet and axilla. 



Disease and Its Treatment 387 



ACNE AND COMEDO. 
Pimples and Black Heads. 

The acne is distended sebaceous follicles found 
mostly on the face and eyelids. They are small, 
white, opaque, seedlike grains. The black heads are 
small, sebaceous plugs, found mostly on the face, 
neck, chest and back. The former may be punctured 
and both should be squeezed out. 

The cause is very obscure from the medical stand- 
point. Osteopathy regards them as being caused by 
poor nerve supply and deficient circulation to the skin 
and superfical fascia. Upon improving the circula- 
tion and bettering the nerve supply they disappear. 

The treatment is largely directed to the neck. The 
muscles are well worked and kneaded, and some 
treatment, though not so severe, is given to the face 
or part affected. Treat about twice per week for a 
while and then once per week. If there are any in- 
dications of constitutional weakness a general treat- 
ment is indicated. 



388 Practice of Osteopathy 



HICCOUGH, OBSTINATE. 

Hiccough is a reflex spasm of the diaphragm with 
simultaneous closure of the glottis. It is a very dis- 
tressing trouble and if continued for several days 
may prove fatal. I have noted cases that stopped 
while the patient slept and began upon awakening. 
It is sometimes very difficult to cure. In the milder 
forms a sudden reflex irritation will cure at once. A 
teaspoonful of salt and lemon juice has been recom- 
mended. Salt and vinegar will do as well. Strong 
traction on the tongue may cure. 

The Osteopathic treatment calls for a thorough re- 
laxing of the neck muscles. I have found cases 
where the hyoid bone was pulled backward and 
downward and relief was secured at once by forcibly 
elevating the bone with the fingers. Sometimes firm 
pressure is to be applied upon the phrenic nerve, 
over the scalenus anticus muscle. This inhibits the 
action of that nerv^e. The same effect may be ob- 
tained by the application of cold. This nerve ener- 
vates the diaphragm. 



Disease and Its Treatment 389 

EPISTAXIS. 
Nose Bleeding. 

Bleeding from the nose may occur from a variety 
of causes — injuries, nasal diseases and erosions. It 
may be caused by general conditions, as in the case 
of delicate children about the age of puberty. In 
stout persons it may indicate liability to apoplexy. 
It is common in ascending heights, as in mountain 
climbing, or ascending in balloons. Bleeding from 
the nose precedes typhoid fever and is common in 
anaemias. In cases of suppression of the menses the 
epistaxis is sometimes vicarious. 

The treatment in most cases is very simple. In 
many cases it stops itself. In case the bleeding is 
obstinate, hot or cold water may be injected into 
the nose. Alum, an astringent, may be used. A me- 
chanical form of treatment will be simply to hold the 
hands of the patient above his head. The operator 
may place his thumbs just beneath the nose, on the 
upper lip, and his forefinger in the notch of the 
facial artery, which is found about one-half an inch 
forward of the angle of the lower jaw. Pressure 
may be made here for five minutes and repeated if 
necessary. This form of treatment is illustrated by 
Fig 23 A. When the bleeding is very bad and obsti- 
nate it will be well to plug the posterior nares, using 
absorbent cotton which has been well saturated with 
alum water or tannin and glycerine. Remove on the 
third day and renew if necessary. 



390 Practice of Osteopathy 



SUNSTROKE. HEAT-EXHAUSTION. 

Sunstroke Is caused by excessive exposure to heat. 
Any factor that lessens the bodily resistance to a 
high temperature will predispose to sunstroke. Ex- 
haustion of mind or body, excitement or worry, ac- 
companied by unsanitary conditions, overeating, al- 
coholism, previous attacks, when coupled with ex- 
posure to extreme heat will bring on the condition. 
When the atmosphere is hot, still, sultry and humid, 
working hard in the direct rays of the sun predis- 
poses to heat-stroke. It may be brought on by labor 
in poorly-ventilated, excessively hot, close and con- 
fined places. 

The symptoms come on suddenly. There may be 
loss of consciousness and the face is flushed, while 
there is full, rapid pulse. The skin is hot and dry. 
The temperature is from 100 to 106. In fatal cases 
the coma becomes deeper and deeper, the pulse is 
more rapid, and the temperature may reach from 106 
to 115. Heat-exhaustion may have more warning 
symptoms. There may be headache and nausea, with 
faintness and thirst. The extremities may have 
numbness and tingling. These symptoms will be 
followed by great muscular weakness and prostration. 
There will be clamminess and coldness of the sur- 
face, with pallor and a small, rapid pulse. In grave 



Disease and, Its Treatment 391 

cases there may be collapse. The temperature is at 
first subnormal, 95 to 97, though in some cases there 
may be a mild fever, ranging from 100 to 102. We 
look for such cases to recover in one or two days 
and with prompt treatment in a few hours. When 
the patient is weak death may take place. 

Treatment. Notice the difference in treating the 
two cases. In sunstroke, promptly place in an ice 
bath, with plenty of ice in the water. Reduce the 
temperature to 101. Take from the bath and rub 
the patient dry. Then thoroughly loosen all spinal 
muscles. See paragraphs 47, 48, 49, 53, 54, 56, 57, 
58, 59, 60. All of these movements may not be neces- 
sary in some cases, but use as many as you need 
thoroughly to relax all spinal tissues. Pay especial 
attention to the neck. See that there are no con- 
tracted tissues in the neck. See paragraph 5, 
also use paragraph 7 as indicated in Fig. 7B. 
Also Figs. 8 and 9A. Give an inhibitive, re- 
laxing treatment to the abdomen. See para- 
graphs numbered from 94 to 100. In case the 
temperature is again rising, repeat the bath, but do 
not lower the temperature below 101. To lower 
the temperature an ice water enema is a useful help. 
Use an ice cap for the head, and give a liquid diet 
for several days. In case of heat-exhaustion get 
the patient into the shade in a cool place. Loosen 
all clothing, especially about the neck. If the tem- 
perature is subnormal use a warm bath. Give a little 
brandy and treat Osteopathically as in sunstroke. 

Extra precaution should be taken in warm weather 



392 Practice of Osteopathy 

by those who do physical work. Sleep in a well- 
ventilated room. Bathe frequently. Avoid alcohol 
and heavy eating. Stop work and seek the shade at 
once if sweating stops. Wear cool, wet cloths or 
green leaves inside a light hat. 



Disease and Its Treatment 393 



ALCOHOLISM AND DRUG HABITS. 

Morphine, Cocaine and Cigarette Habits. 

Alcoholism is accompanied by profound tissue 
changes in various parts of the body. It often results, 
when long continued, in a chronic inflammation of 
the liver, stomach, heart, blood vessels and kidneys. 
Neuritis, epilepsy and paresis may be caused by the 
disease. 

The drug habits produce changes in the nerves and 
operate to change the character of the patient. 

In treating alcoholism we give a thorough general 
treatment each day for about two weeks, and after 
that every other day for from one to three months. 
Should there be constipation, liver or kidney 
troubles, special treatment should be given for these 
diseases. We give special attention to the treatment 
of the pancreas, spleen and liver. In treating the 
spleen and pancreas the location for spinal work is 
the same as for the liver. In working over the spleen 
we treat the same as for the liver, remembering that 
they are on opposite sides of the body. 

The founder of Osteopathy believes that the 
chronic drinker has the thirst for liquor in a more 
aggravated form because there is some failure of the 
system to supply healthy fluids, and the thirst for 
alcohol is nature craving a substitute. While the 
patient is undergoing the treatment he should be well 



394 Practice of Osteopathy- 

fed. The system must be well nourished and built 
up. Allow beef tea and malted milk with red pepper 
to be taken when the thirst for strong drink is ex- 
cessive. Treating such cases is not very pleasant 
work, but there is great satisfaction in saving such 
men to their families. 

The doctor must use considerable firmness and 
tact in dealing with these cases. Each one is 
different and requires different treatment. One 
man was made to promise that he would come 
to me when he had to have a drink. I prom- 
ised to give it to him and did so, but he was 
eventually cured. One man after he had been under 
treatment for a week said he felt as if his delirium 
tremens was coming on again (he had been confined 
for this cause). He begged for a quart of whiskey. 
In the presence of his wife, who had accompanied 
him to the office, I told him he might take a quart 
home. He consumed three-fourths of it that night. 
A little over a year after this he was accidentally 
killed, but he had never touched a drop of whiskey 
since that night. 

In treating the drug habits the same treatment as 
for alcoholism is given. Morphine must be gradu- 
ally withdrawn. Coffee may be used as a stimulant. 
The cocaine habit is, perhaps, the most difficult to 
overcome. Its victims are most pitiful. The drug 
must be gradually withdrawn. Great excitement, 
sometimes paranoia, follows its discontinuance. The 
treatment will be best given in an institution where 
you can have absolute control of the patient. 



Disease and Its Treatment 395 

WORMS. 

Tape Worms (Cestodes), Round Worms (Ascaris 

Lumbricoides), Pin Worms (Oxyuris Ver- 

micularis), Thread Worms. 

Tape Worms. There are two varieties, in the 
United States, of tape worms, the taenia solium and 
the taenia saginata. They are allowed to secure an 
entrance into the system by eating raw or partially 
cooked beef or pork, which had previously become 
a host for the eggs of the worm. There are numer- 
ous symptoms, but the only sure method of diagno- 
sis is to find segments of the worm which have been 
passed in the stools. 

There is a long list of drugs that are effective, the 
best of which is the oleroesin of the male fern. This 
should be given in a capsule. For a child ten years 
old the dose should be 15 minims, four of which 
should be taken at hourly intervals. Immediately 
after the last dose take one-half an ounce of castor 
oil. Very little should be eaten the day before, and 
a dose of salts should be taken the previous evening. 
Nothing should be eaten in the morning when the 
treatment begins. 

An adult may take a two-drachm dose of the 
ethereal extract of the male fern, followed in two 
hours by an active purge. When the worm is being 
passed warm water should be placed in the com- 
mode. This keeps the worm from contracting and 
breaking. 

Another splendid remedy is to take three or four 



396 Practice of Osteopathy 

ounces of pumpkin seeds, bruise and macerate them 
for half a day. This infusion is to be taken after 
a fast, and the bowels thoroughly cleansed by a 
salt-water injection and a dose of Epsom salts. Fol- 
low the infusion of pumpkin seeds in an hour by a 
thorough purge. Unless the head of the worm is ex- 
pelled the segments will again appear in the faeces 
in about three months. 

Round Worms. 

These are small and round, from five to ten in- 
ches long, tapering at the ends, grayish in color, 
with sometimes a pink tint. Generally there are 
from two to ten of them, but there may be many 
more. 

Sometimes they migrate, enter the stomach and 
are vomited. They have been known to enter the 
nose, the middle ear and the bile duct. They cause 
a number of nervous symptoms. Positive evidence 
of their presence is their appearance in the stools. 

The best remedy is sanotin. A one-grain dose is 
enough for a child five years of age, and three should 
be given at hourly intervals in the powdered form, 
mixed with pulverized sugar. This should be pre- 
ceded by a day of fasting and a dose of salts at 
night and next morning. After it acts the remedy 
may be given, and should be followed by an active 
purge, say one-half ounce of castor oil. 



Disease and Its Treatment 397 

Pin Worms, 

They are very much like short pieces of white 
thread. The worm is from one-sixth to one-third of 
an inch in length and tapers toward the tail. 

These worms cause intense itching, usually at 
night, because they migrate to the anus and to the 
genital organs, where they cause inflammation and 
may lead to masturbation. Large quantities of 
mucus may be discharged from the bowels. Ir- 
regular nervous symptoms may be caused, which 
sometimes lead to convulsions. The worms may be 
found in the faeces or on the person near the rec- 
tum. 

Treatment. Cold injections of strong salt water 
are very helpful. Strict attention must be given 
at all times to absolute cleanliness, to avoid reinfec- 
tion. A solution of bichloride of mercury, 1 to 10,- 
000, may be used to bathe the anus two or three 
times per day. This is also a splendid injection, and 
may be used after an injection in which one tea- 
spoonful of borax to a pint of water has been used, 
to remove the mucus. After the mucus comes away 
use about half a pint of the bichloride of mercury 
solution. Retain as long as possible and repeat 
every third or fourth night. On the other evenings 
use the salt water injections and occasionally give 
a dose of Epsom salts. 

One very obstinate case was cured by using as au 
injection a decoction of garlic. At the same tini^ 
large quantities of garlic were used by the mouth. 



398 Practice of Osteopathy 

The itching may be allayed by the use of carbol- 
ized vaseline. 



CHILBLAINS. 

When the chilblains affect the feet, care should 
be taken to keep up a good circulation. Loose 
shoes, with woolen stockings, should be worn. Fre- 
quent bathing, followed by vigorous friction, will 
be of value. An occasional application of a lini- 
ment composed of equal parts of turpentine and olive 
oil may be rubbed on. at night. 

The itching may be allayed by rubbing in the fol- 
lowing ointment: 

Powdered camphor 1 dram. 

Ichthyol 1^ drams. 

Lanolin i/^ dram. 

Cosmolin 4 ounces. 

FROST-BITE. 

A person with any part of the body frost-bitten 
should not be brought into a warm room. The part, 
if recently frozen and red in color, should be rubbed 
with snow or with cloths dipped in ice water until 
the redness disappears. If the person is nearly 
frozen to death, induce breathing by using the meth- 
ods for artificial respiration, which see. See Figs. 
106, 107. Rub him thoroughly with flannel satu- 
rated with whiskey. Apply vigorous pressure on the 
spine between the shoulders, as in No. 67. Give an 



Disease and Its Treatment 399 

enema of brandy and water. When possible admin- 
ister brandy by the mouth. Give warm drinks, as 
coffee, beef tea, etc. As the patient improves the 
temperature of the room may be raised. 

CORNS. 

These are the result of pressure or friction, and 
when the irritative cause is removed the corn will 
disappear. Salicylic acid is the basis of nearly all 
corn cures. A valuable preparation is: 

Salicylic acid IJ^ drams. 

Extract of cannabis indica . . 10 grains. 

Collodion 1^ drams. 

This may be painted over the corn daily, preferably 
at night, and carefully scraped away in the morn- 
ing. 

If the feet are very much inflamed a very grate- 
ful treatment will consist of a thorough cleansing 
with ethereal soap. Soak in hot water and wrap 
them in cloths which have been soaked in the fol- 
lowing : 

Linseed oil 2 ounces. 

Lime water 2 ounces. 

Spirits of camphor 1 dram. 

Soft corns may be treated by washing the feet 
thoroughly with ethereal soap. After drying care- 
fully remove the dead and loosened skin. Dust 
the toes with borated talcum powder and place a 
thin layer of absorbent cotton between. 



400 Practice of Osteopathy 

BURNS. 

Sun burns, or burns slight in character, may be 
kept moistened with a saturated solution of bicar- 
bonate of sodium (common baking soda). When 
the burn is more serious the following ointment 
should be used: 

Iodoform 20 grains. 

Antipyrin 75 grains. 

Boric acid 75 grains. 

Vaseline 1^ ounces. 

Burns of a very serious nature call for immediate 
surgical attention. 

IVY POISONING. POISON OAK. 

Portions of the body exposed are often covered 
with blisters. There is great swelling, itching and 
burning. Apply the following solution : 

Grindelia robusta 4 drams. 

Water 1 pint. 

Later a salve made as follows may be applied: 

Carbolic acid 10 grains. 

Boric acid 30 grains. 

Petrolatum 1 ounce. 

WARTS. 

For warts on the face apply each day some of the 
following prescription : 

Subliminal sulphur 5 drams. 



Disease and Its Treatment 401 

Glycerine 1^ drams. 

Acetic acid 2^ ounces. 

For warts on other parts o£ the body a very effect- 
ive application is to paint daily with the following: 

Corrosive sublimate . . . .^ of a dram. 

Collodion 15 drams. 

It is a well known fact that if a wart is kept 
constantly wet with castor oil it will frequently 
drop off and disappear. Another useful application 
is: 

Resorcin 30 grains. 

Alcohol , 1 ounce. 



402 Practice of Osteopathy 



HAY FEVER. 

In addition to the regular Osteopathic treatment 
for hay fever, as noted on page 242 of this work, the 
attention of the reader is called to some additions 
in the technique and modus operandi of the treat- 
ment. Before beginning this special work it will be 
well thoroughly to irrigate the upper nasal pas- 
sages with a salt solution at a temperature of about 
105 degrees Fahrenheit. This solution should be 
conducted from a glass container, elevated about 
three feet above the head of the patient, through the 
medium of a rubber tube. As the patient bends 
over a fountain cuspidor, the solution should be 
made to enter one nostril and flow out of the other. 
About a quart of this solution may be used at one 
time. When a pint has been used, the rubber tube 
with its nasal attachment may be transferred to 
the other nostril. This solution, by an effort on 
the part of the patient, may be made to enter the 
mouth, and thus it will assist in cleansing the naso- 
pharynx. This solution may be prepared in the 
following manner: Five ounces of sodium chloride 
(common salt) ; three and one-half ounces of sodium 
biborate (borax) ; two ounces of bicarbonate of soda 
(common baking soda). This may be kept for all 



Disease and Its Treatment 403 

practical purposes in a dry state. The ingredients 
should be thoroughly mixed, and then a teaspoon- 
ful may be used in each quart of water intended for 
the irrigation. 

On beginning the treatment it is advisable to use 
about three teaspoonfuls, and as the treatment 
progresses it may be reduced to one. The stronger 
the solution the greater is its cleansing power. But 
if it is used too long a time at its maximum strength 
it will tend to irritate the mucous membrane of the 
nasal passages. 

When these antiseptic precautions have been tak- 
en, the forefinger of the operator may be thorough- 
ly cleansed, upon which is used a mild antiseptic. 
A ten per cent solution of iodine and glycerine will 
be excellent for this purpose. The finger is inserted 
back of the soft palate, at one side of the uvula. 
The soft palate may then be pulled forward and 
bent at almost right angles with the hard palate. A 
short, simple massage treatment may be given it, 
and this will tend to reduce its size, as in these 
cases it is often found enlarged. The soft palate may 
be swept from side to side and the back of the finger 
may sweep over the posterior part of the naso- 
pharynx. This tends to break up any pockets in 
which mucus may collect and assist in cleansing 
out this space. After this is done the cleansing solu- 
tion may be used for a short period as a douche as 
before, and the mouth thoroughly cleansed. In 
order to keep these membranes from any undue ir- 



404 Practice of Osteopathy 

ritation until the natural secretions have been 
established, pinoleum may be used as a spray in 
the nostrils or glycothymoline may be used on a 
cotton applicator. If this treatment is commenced 
several weeks before the time for the hay fever to 
put in an appearance, we may hope to effect a cure, 
or greatly benefit the patient. 

The treatment should be given about three times 
per week. If you do not get to treat the patient 
until the disease is active, we may hope, by admin- 
istering the treatment each day for several days, 
to give the patient considerable help. 

THE TREATMENT OF DEAFNESS AND 
PARTIAL DEAFNESS. 

Great strides have been made in the past few 
years by various members in the Osteopathic pro- 
fession in the treatment of deafness and partial 
deafness. This has been especially true when the 
deafness was caused by catarrh. The exudates from 
the catarrhal condition partially fill the Eustachian 
tubes. The special Osteopathic procedure is di- 
rected to the opening up of these tubes, and the 
normalization of all surrounding tissues. This 
should go hand in hand with the general Osteo- 
pathic treatment, which has for its purpose the 
loosening up of all the tissues of the neck and upper 
dorsal regions of the back. Many Osteopaths con- 
sider this to be of first-class importance. It has been 
the experience of a number of Osteopaths in giv- 



Disease and Its Treatment 405 

ing their regular treatment, in which it has been 
necessary to do considerable work in the upper part 
of the back and the neck, to find patients laying aside 
their glasses and having their ears improved, when 
the treatment was not especially directed either to 
the eyes or the ears. 

The antiseptic precautions, and the method of 
irrigation with the same salt solution, as noted here 
in the treatment of hay fever, are used in the treat- 
ment of deafness and partial deafness. In treating 
the ears it will be best to look after the general 
health of the patient, in order to obtain the best re- 
sults. Nervousness, stomach troubles, liver diseas- 
es, female troubles, overeating and drinking, all tend 
to aggravate most cases of deafness. The appropri- 
ate prohibition of all bad habits should be made, and 
in some cases the proper diet should be followed. 

Some cases of head noises are caused by too high 
blood pressure. The careful physician will take the 
blood pressure of most of his patients and work to 
reduce such pressure as is above normal. 

Before accepting a case of deafness or partial 
deafness it will be well to make certain tests with 
the tuning-fork, and also give the watch test, and an 
examination of the outer ear should be made, and 
also the nasopharnyx. You should determine 
whether the deafness is caused by the impairment of 
the essential organ of hearing, or the conduction ap- 
paratus; whether the difficulty is in the labyrinth 
or auditory nerve, or whether it is due to an obstruc- 



406 Practice of Osteopathy 

tion of the Eustachian tube, the external auditory 
canal, or some affliction of the tympanic membrane. 
We expect, under our treatment, greatly to benefit 
those cases where the deafness, or partial deafness, 
is due to some impairment of the conducting ap- 
paratus. And we find that the greater part of deaf- 
ness is due to the latter cause. In testing any par- 
ticular case it will be best to use the tuning fork. 
If it be impractical to have a number of forks, the 
best fork adapted for ordinary use will be one that 
is fairly loud and one sounding the note C2; that is, 
512 vibrations per second. 

When a vibrating tuning fork is placed against 
the head of a person whose hearing is entirely 
normal, he will hear it better if both ears are closed. 
Or if one ear is closed he will hear the fork better 
in that ear. So, if the hearing in one ear is im- 
paired because the Eustachian tube is closed from 
any cause, the vibrating tuning fork will be better 
heard in that ear. This will also be the case if the 
external auditory canal is obstructed, or if the men- 
brana tympani is thickened. In making this test 
the handle of the tuning fork should be held against 
the teeth, or on the head midway between the ears. 
If the difficulty in hearing is due to an affection of 
the labyrinth or of the auditory nerve, the vibrat- 
ing tuning fork will not be heard as well in the im- 
paired ear. 

Some persons will imagine that they hear the 
tuning fork better in the ear in which they are ac- 



Disease and Its Treatment 407 

customed to hear well, under other circumstances. 
Ask the patient to listen to the fork as he closes 
first one ear and then the other. Be sure that he 
hears as he really does, not as he thinks he ought to 
hear. 

Another test that may be used in connection with 
the tuning fork will be the watch test. For this 
purpose a common Ingersoll dollar watch which has 
a loud tick will be best. It may be well to use in 
connection with this a better grade watch, whose 
tick has a greater number of vibrations. Be certain 
to have the room in which the test is made free from 
all noise. Have the eyes of the patient covered. 
Hold the watch on a level with the ear, and move 
it slowly towards that organ. By testing in this 
way it will be an easy matter to know how the case 
is progressing as each treatment is being given. 

When you are examining a case for the first time 
it is always well to examine the exterior auditory 
canal and the membrana tympani. A reflector and 
ear speculum will be useful for this purpose. The 
writer uses a head lamp which throws its light into 
the ear, and a nest of Gruber's specula. Sometimes 
you will note a thickening of the membrane, and the 
exterior ear often is filled with cerumen or other 
matter, and must be removed. Frequently you will 
find cases of deafness where this is the only thing 
necessary to do. A mass of such material, after be- 
ing made soft, can readily be removed by syringing 
with warm water. Have the patient soften it by 



408 Practice of Osteopathy 

filling the ear with warm water several times a day, 
and at night introduce a few drops of sweet oil. 
Then, the next day, you can syringe the ear and re- 
move the mass in this manner. 

Examination of the Nasopharynx. 

In examining a patient, where you expect that 
the deafness is induced by catarrh affecting the 
Eustachian tubes, it will be well to examine the 
nasopharynx. For this purpose it is well to have 
several small mirrors, ranging in size from 00 to 5. 
The frames of these mirrors are attached to wire 
handles at an angle of forty-five degrees. One of 
these mirrors is slightly warmed and introduced in- 
to the open mouth of the patient. It should be 
carried back to the pharyngeal cavity while holding 
the tongue down with a tongue depressor. It should 
be so placed that it will reflect the light into and 
upward, so as to obtain a good image of the vault 
of the pharynx and the posterior nares. We note 
the posterior margin of the nasal septum, the pharyn- 
geal tonsil just above it, and still lower, on each 
side, are the pharyngeal orifices of the Eustachian 
tube. They look like two open elevations. They 
have a border of cartilaginous Hps which, in the 
normal state, has a deep-red color, while the mucous 
membrane at the tube entrance is lighter in color. 
If the mucous membrane covering the lips of the 
tubes is lighter in color and the parts appear shrunk- 
en, the tubes are atrophied. If the Eustachian tube 



Disease and Its Treatment 409 

mouth appears dilated and swollen, and there is 
mucus showing in it, catarrh of the tube is indi- 
cated. 

Difficulties of This Examination. 

We should not touch the back of the tongue or 
wall of the pharynx, as a gagging of the patient will 
start and we cannot proceed with the examination. 
Should the palate rise and shut off our view we may- 
request the patient to breathe through the nose. To 
this end it will be best to have the patient take a full 
breath as you insert the mirror, and then request 
him to exhale through the nose. 

The Treatment Proper. 

After you have selected your case and you are 
certain that the external auditory canal is open and 
free of wax, or other deposit, and that the essential 
organ of hearing is not seriously impaired, we ex- 
amine the Eustachian tubes by means of the small 
throat mirrors. 

Then, if they are closed, or partially so, we care- 
fully insert the forefinger back of the soft palate, at 
one side of the uvula, on the same side that the tube 
is closed. Run the palm of the finger outward and 
forward until you reach the tubercle back of the 
mouth of the Eustachian tube; then allow the 
finger to go backward into the fossa of Rosenmiiller. 
In doing this do not use too much pressure, but by 
using a little pressure, should there be adhesions or 



410 Practice of Osteopathy 

adenoids, they will be broken up after a few treat- 
ments. About the third or fourth treatment after 
you have inserted the finger as above you may use 
a kind of a stretching and pumping motion over the 
orifice of the tube. This slight manipulation or 
massage tends to open the tube and to clean it of 
mucus. At each treatment pull forward on the soft 
palate. This movement tends to empty the tube. 

After you have treated the patient for about a 
month, three times per week, and you have cleared 
the space about the tube's mouth of adenoids, mor- 
bid growths, and adhesions, you may insert the soft 
tip of the finger into the tube and rotate it a little. 
This will cause pain as it breaks up adhesions. Aft- 
er you have opened the tube thus, you may further 
open it with the Politzer air bag, as directed under 
that head. This should be done two days after the 
finger tips are placed in the tubes. Two days after- 
wards use the air bag again and pull the soft palate 
forward. 

The hand should be well cleaned before the 
finger is inserted in the throat, and a mild antisep- 
tic should be used on the finger. A 10 per cent 
solution of iodine and glycerine will be excellent. 
The patient should use a mild spray or nasal douche 
twice per day, or better after each meal, as long as 
he is under your care. This will tend to keep down 
all inflammation. If, after any of the work, there 
is undue soreness or inflammation, a cold pack may 
be placed over the throat just beneath the chin. 



Disease and Its Treatment 411 

In bad cases it is sometimes necessary to keep up 
the treatment for from three to six months, while 
in some cases, not so severe, pathologically, but 
where the hearing is badly affected, you will ob- 
tain surprisingly good results in a very few treat- 
ments. 

A Simpler Treatment. 

Use the above technique, but very lightly, three 
times on the first day. The second day use it twice, 
and perhaps also on the third day. Then use it 
daily for awhile. Then treat three times per week 
for two weeks. But do not attempt to place the 
finger in the tube mouth. Use antiseptic precau- 
tions as above. During the last week of treatment 
use the Politzer air bag once or twice. This mas- 
sage in many cases will open up the tube. Be sure 
to massage the tubercle of Gerlach and spring the 
soft palate forward. This loosens the folds in the 
tube and forces out the mucus. In cases which are 
quite deaf, but in which the pathological conditions 
are not so very serious, you may expect good re- 
sults in a very short time. Be sure always to work 
over and massage an enlarged soft palate. This is 
for the purpose of reducing its size. This treatment 
will improve a speaker's or singer's voice. 

The Simplest Treatment. 

The simplest and easiest method that I have found 
for clearing out the Eustachian tubes, and at the 



412 Practice of Osteopathy 

same time restoring their patency, is to treat over 
them each day for a week or ten days before using 
the PoHtzer air bag. They can be reached for the 
purpose of expressing the mucus by treating over 
the anterior wall of the nasopharynx, just to one 
side of the uvula and soft palate. In this way you 
reach the Eustachian tube through the wall of the 
nasopharynx, and treat the tube much as you would 
treat the appendix, manually, through the abdomen. 
Use the same antiseptic precautions as in the 
treatments noted above. 

The Use of the Politzer Air Bag. 

Place the nosepiece of the bag in one nostril and 
close both nostrils about this nosepiece with the 
thumb and finger. A little water having been 
previously placed in the patient's mouth, he is told 
to swallow. As soon as the operator notes the lar- 
ynx rise as the patient begins to swallow, he quick- 
ly presses the bag, thus forcing the air into the 
Eustachian tube and on up to the middle ear. Do 
not use any more force to accomplish this purpose 
than necessary. You had better make several at- 
tempts than to cause pain or possibly rupture a 
diseased drum membrane. You can inflate the mid- 
dle ear of a child easier than that of an adult. For 
the average practitioner an eight-ounce bag will be 
the best. 



INDEX 



Abdomen, Examination of, 48 

" Treatment of, 49 

Abdominal Tumors, 374 

Abnormal Spine, , 62 

Abnormality, Careful of, 9 

Acne, 387 

Acupuncture, 352 

Acute Articular Rheumatism, .... . , 259 

" Bright's Disease, 310 

" Cystitis, 305 

" Nasal Catarrh, 242 

" Nephritis, 310 

" Poliomyelitis, .338 

Addison's Disease, 308 

Adenia, 318 

Aestvo-Atumnal Fever, 197 

Affection of Joints, 378 

Agitans Paralysis, 367 

Ague, 203 

Albuminaria, See Bright's Disease, 312 

Albumen, Examination for, 310 

Alcoholism, 393 

Alveolar Emphysema, 249 

Anaemia, 329 

Idiopathic, 332 

" Pernicious, 332 

Toxic, : 329 

" Secondary, 329 

Anatomy, 11 

A-ngina Pectoris, 328 

Ankle, Dislocation of, 58 

Ankylosis, 189, 379. 194 

Anuria, 307 

Aphonia, See Loss of Voice, 25 

Appendicitis 280 

Apoplexy, Cerebral, 340 



Practice of Osteopathy 

Arches, Weak, 383 

Argyll-Robertson Pupil, 370 

Arrangement of Vertebrae, 64 

Arrhythmia, 326 

Arteriosclerosis, 315 

Articular Rheumatism, Acute, 259 

Artificial Respiration, 380, 381 

Arthritis Deformnans, 262 

Ascites, 313 

Asthma, Bronchial, 245 

Astigmatism, 376 

Ataxia, Locomotor, 369 

Ataxic Paraplegia, 368 

Atheroma, 315 

Atlas, Examination of 22 

" Treatment of, 25 

Atrophy of Optic Nerve, Zld 

Autumnal Catarrh, 241 

Axis, Examination of, 22 

" Treatment of, 24 



B 

Back, 31 

" Examination of, 31 

" Treatment of, 32 

Basedow's Disease, 335 

Bed Wetting, 303 

Benign Tumor, 307 

Big Neck, 334 

Bilious Remittent Fever, 197 

Black Heads, 387 

Bladder, Inflammation of, 305 

Blindness ZTd 

Blood, Diseases of, 329 

Bloody Flux, 297 

Bow Legs, 378 

Brachial Neuralgia, 347 

Neuritis, 348 

Brachycardia, 326 

Breaking-up-Treatment of Spine, 33 

Breast Pang, 328 

" Tumors of, Z7^ 

Breathing, Correct, 239 

Bright's Disease, Acute, 310 

Chronic, 312 



Index 



Bromidrosis, 386 

Bronchial Asthma, 245 

Bronchitis, Acute, 244 

Capillary, 219 

Chronic, 245 

Bronchocele, 334 

Bronchopneumonia, 219 

Burns, 400 



C 

Cancer, 374 

Cancerous Tumors, 374 

Capillary Bronchitis, 219 

Caput Medusae, 290 

Cartilage Thyroid, 25 

Cataract, ~7il6 

Catarrh, Acute Nasal, 242 

Autumnal, 241 

" of Stomach, 273 

Catarrhal Jaundice, 285 

" ^ Pneumonia, 219 

Cephalgia, 371 

Cerebral Hemorrhage, 340 

" Apoplexy, 340 

Cerebro Spinal Fever, 212 

'; '; Meningitis, 212, 338 

Cervical Region of the Spine, 64 

Cestodes, 395 

Chest, Examination of, 43 

" Treatment of, 42 

Child's Curve of Spine, 64 

Chilblains, 398 

Chicken Pox, 208 

Chills and Fever, 203 

Chiropractic Treatment, 13 

Chlorosis, 331 

Cholangitis, 290 

Cholelithiasis, 287 

Chorea, 357 

Cholera Infantum, 296 

Morbus, 295 

" ^ Nostras,^ 295 

Chronic Interstitial Hepatitis, 292 

Circulatory System, Diseases of 315 to 329 

Cirrhosis of Liver, 290 



Practice of Osteopathy 

Cirrhosis oi Liver, Hypertrophic, 290 

Clavicle, Examination of, 42 

" Treatment of, 42 

Cocaine Habit, 393 

Coccyx, Examination of, 41 

" Treatment of, 41 

Coccygeal Curve of the Spine, 64 

Cold Compresses, 218 

Cold in the Head, 242 

Colas, General, 214 

Compresses, 218 

Congestion of Kidney, 309 

" Liver, 290 

" Lungs, 247 

Confluent Small Pox, 210 

Conj unctivitis, 376 

Contraction of Spinal Muscles, 10 

Constipation, 299 

Consumption, 234 

Corns, 399 

Cortical Epilepsy, 359 

Coryza, Acute, 242 

Corpulence, 214 

Cramps, Milker's, 366 

Pianist's 366 

Cigar Maker's, 366 

" Telegrapher's, 366 

Writer's, 366 

Crossed Eyes, 376 

Croup, 225 

False, 244 

Croupous Pneumonia, 216 

Curvature of Spine, Functional, 190 

" Structural, 190 

" Transitional, 190 

" Rotary, 189 

Curves of Spme, Cervical, 64 

" " Coccygeal, 64 

" " Dorsal, 64 

" in Infant, 64 

" " Lumbar, 64 

" Normal, 64 

Sacral, 64 

Cystic Tumors, 374 

Cystitis, 305 

Danger in Treating, 13 



Index 



Deafness, 378 and 404 

Deep Breathing, 239 

Degeneration of Liver, 292 

" Heart, 323 

Deformities, 378 

" See Curvatures, 190 

" See Dislocations, 57 

Diagnosis, Methods of, 16 

Diabetes Mellitus, 257 

" Insipidus, 256 

Diarrhoea, 298 

Diet in Tuberculosis, 240 

" See Each Disease. 

Digestive Tract, Diseases of, 266 to 302 

Diplopia, Vd 

Diphtheria, 221 

Diseases, Basedow's, 335 

Graves', 335 

Parkinson's, 367 

Pott's, 191 

of the Bladder, 305 

" " Circulatory System, 315 

" " Blood, 329 

Cardiac, 323 

of the Digestive Tract, 266 to 302 

" Ear, 377 

" Eye, 376 

" Heart, 323 

" Intestines, 280 

" Kidneys, 307 to 313 

" Larynx, 243 

" Liver, 290 

" Lungs, 234 

" Nervous System, ZZ^i 

" Pharynx, 267 

" Pleura, 249 

" Stomach, 273 

" Respiratory System, 245 

" Thyroid Gland, 334 

" Tonsils, 226 

" Urinary System, 305 to 314 

Dislocation of Ankle, ; 58 

" Elbow, 60 

" Finger, 60 

" Hip, 57 



Practice of Osteopathy 

Dislocation of Knee, 58 

Slight, 378 

of Shoulder, 59 

" Toes, 56 

" Wrist, 60 

Dorsal Region of Spine, 64 

" Curve of Spine, 64 

Dropsy, 313 

Drug Habit, 393 

Dysentery, 297 

Dyspepsia, Acute, 273 

" Chronic, 274 

E 

Ear, 2>n 

Treatment of, 378 

Earache, 378 

Eczema, 223 

of Tongue, 267 

Edema of Lungs, 248 

Elbow, Dislocation of, 60 

" Treated, 60 

Emphysema, 248 

Alveolar, 248 

Hypertrophic, 248 

" Interstitial, 249 

Vesicular, 248 

Endocarditis, 328 

Enlargement of Heart, 329 

Enteritis Catarrhal, 295 

Enteroptosis, 50 

Enuresis, 303 

Epilepsy, 359 

Cortical 359 

" Jacksonian, 360 

Epistaxis, 389 

Erysipelas, 225 

Erythromelalgia, 349 

Examination, Important, 9 

" Preparation for, 10 

of Abdomen, 48 

" Atlas, 22 

« Axis, 22 

" Back, 31 

" Clavicle, 42 

" Coccyx, 41 



Index 



Examination of Head, 28, 30 

" Hyoid Bone, 25 

" " Innominates, 54 

" Limbs, 55 

" Neck, 22, 27 

Office, 20 

of Pelvis, 51, 52 

" Ribs, 43, 47 

" Sacrum, 41 

" Rectum, 67 

Exophthalmic Goiter, 335 

Extra-uterine Tumors, 375 

Eyes, 376 

" Crossed, 376 

" Diseases of, Z76 

" Weak, 377 

Eyelids, Drooping of, 376 

Treated, 30 



Facial Neuralgia, 347 

Fatty Degeneration of the Heart, 323 

" " Liver, ....292 

" Overgrowth of Heart 323 

" Tumors, 374 

Feet, Neuralgia of, 349 

Fever and Chills, 203 

Fever, Hay, 241 

Lung, 216 

Malarial, 203 

Malignant Purpuric, 212 

Petichial, 212 

Rheumatic, 259 

Scarlet, 205 

Spotted, 212 

Typhoid 198 

Fifth Lumbar Vertebra, 40 

" ^ Nerve, Treated, 29 

Fibrinous Pneumonia, 180 

Fibroid Tumors, 374 

Finger, Dislocations of, 158 

Flat Foot, 383 

Flux. Bloody, 297 

Fomentations, Hot, 261 

Fossae, Suboccipital, 202 

Frontal Sinus, 29 

Frost Bite, 398 



Practice of Osteopathy 

G 

Gait, Ataxic, 369 

" in Spastic Paraplegia, 368 

Gall Bladder, Inflammation of, 290 

" " Located, 51 

" Duct, 290 

" Stones, 287 

Ganglion, Middle Cervical, 26 

" Superior Cervical, 26 

Gastralgia, 347 

Gastritis, Acute, 273 

Chronic, 274 

Gastroenteritis, Acute, 295 

General Treatment, Osteopathic, 61 

of Abdomen, 48 

Geographical Tongue, 267 

German Measles, 231 

Glaucoma, 376 

Globus Hystericus, 365 

Goiter, Exophthalmic, 335 

Simple, 334 

Gout, 264 

Grand Mai, 359 

Granular Liver, 290 

Granulated Lids, 376 

Graves' Disease, 335 

Grippe, La, 206 

H 

Habit, Cigarette, 393 

" Cocaine, 393 

Drug, 394 

Morphine, 394 

Hands, in Treating, 49 

Hay Fever, 241 and 402 

Head, Examination of, 28 

" Treatment of, 30 

Headache, 372 

Sick, 371 

Heart, 321 

" Dilatation of, 329 

" Diseases of, 323 to 329 

" Enlargement of, 329 

" Fatty Degeneration of, 323 

" " Infiltration of, 323 



Index 



Heart, Fatty Overgrowth of, . . .- 323 

" Hypertrophy of, 329 

" Palpitation of, 326 

" Valvular Lesions of, 324 

" Irritable, 327 

Heat-Exhaustion, 390 

Hemicrania, 371 

Hemiplegia, 336 

Hemorrhage, Cerebral, 340 

of Lungs, 235 

" Stomach, 235 

Hemorrhoids, 278 

Hemothorax, 251 

Hepatitis, Chronic Interstitial, 290 

Hiccough, 338 

Hip, Dislocation of, 57 

Hives, 277 

Hob-Nailed Liver, 290 

Hot Fomentations, 261 

Hydropneumothorax, 251 

Hydrothorax, 251 

Hyoid Bone, Examination of, 25 

" Treatment of, 25 

Hyperemia of Liver, 292 

Hypertrophic Cirrhosis of Liver, 290 

Hypertrophy of Heart, 329 

Hysteria, 364 

Hysteroepilepsy, 364 

I 

Icterus, 285 

Iliac Spines, 54 

Impaired Vision, Z16 

Incontinence of Urine, 303 

Indigestion, 274 

Infant, Normal Curve of Spine, 64 

Infantile Paralysis, 338 

Infectious Diseases, 205 

Infiltration of Liver, 292 

Inflammation of Bowels, 293 

" Gall Duct, 290 

" Veins, 316 

Inhibition of Spine, 40 

Innominates, Examination of, 54 

" Lesions of, 54 

" Treatment of, 55 



Practice of Osteopathy 

Insanity, 355 

Insomnia, 346 

Inspection, 16 

of Spine, 189 

Intercostal Neuralgia, 347 

Interstitial Nephritis, 312 

" Tumors, 307 

Intestinal Obstruction, 283 

Tumors, 284, Zn 

Intestines Raised, 50 

Intra-uterine Tumors, 375 

Intussusception, 283 

Invagination of the Bowel, 284 

Ischia, Treatment of, 62 

Ivy, Poison, » .400 

J 

Jacksonian Epilepsy, 360 

Jaundice Catarrhal, 285 

Obstructive, 286 

Joint Affections, 378 

Joint Deformed, 311 

K 

Keratitis, , . . . . 376 

Kidney, Cirrhosis of, 312 

Congestion of, 309 

Contracted, 312 

Floating, 309 

Inflammation of, 310 

Movable, 309 

Palpable, 309 

Knee, Dislocation of, 58 

Knee-jerk, Loss of, 370 

Koplick's Sign in Measles, 230 

Kuatsu, 381 

Kyphosis, 193 



La Grippe, 206 

Laryngitis, Acute, , . .243 



Index 

Laryngitis, Chronic, 245 

" Spasmodic, 244 

" Stridulus, 244 

Legs, Bowed, 378 

Lesions, Determined, 11 

" Innominate, 54 

" Ligamentous, 25, 32 

" Osteopathic, 11 

Pelvic, 50 

Produced Reflexly, 10 

of Ribs, 43 

of Spine, 31 

Lids, Granulated, Z1(i 

" Drooping, 377 

Ligamentous Lesions, 25, 32 

Ligaments, Sacro-iliac, 41 

Limbs, Examination of, 55 

" Old Subluxations of, 57 

" Treatment of, 57 

Liver, Atrophic Cirrhosis of, 290 

Cirrhosis of, 290 

Congestion of, 293 

" Degeneration of, 292 

Fatty, 292 

Granular, 290 

Hob-nailed, 290 

Hyperemia of, 292 

" Hypertrophic Cirrhosis of, 290 

Infiltration of, 292 

Nutmeg, 290 

Treatment of, 291, 293 

Lobar Pneumonia, 216 

Lobular Pneumonia, 219 

Locomotor Ataxia, 369 

Lordosis, 31 

Loss of Voice, 25 

Lumbago, 352 

Lumbar Curve of Spine, 64 

" Region of Spine, 64 

Lung Fever, 216 

Lungs, Congestion of, 247 

" Edema of, 248 

" Hemorrhage of, 235 

" Tuberculosis of, 234 

Lymphadenoma, 318 



Practice of Osteopathy 

M 

Malarial Fever, 203 

Malignant Purpuric Fever, 212 

" Tumors, 374 

Measles, 230 

German, 231 

Meningitis, Acute, 212, 338 

" Cerebro Spinal, 212 

" Spinal, 213 

Infantile, 338 

Mental Disorders, 355 

Methods of Diagnosis, 16 

Migraine, 371 

Mollities Ossium, 195 

Morbilli, .230 

Morphine Habit, 393 

Mouth, Diseases of, 266 

Dry, 266 

Inflamed, 266 

" Opened Against Resistance, 26 

Ulcers of, 267 

Mumps, 240 

Muscle, Pyriformis, 364 

Muscles, Diseases of, 350, 352 

Pain in, .350 

Scaleni 24 

Muscular Rheumatism, 350, 351 

Myalgia, 351 

Myocarditis, 328 

N 

Nasal Catarrh, 242 

Neck, Examination of, 22, 27 

" Spiral Treatment of, 27 

Stiff, 351 

" Treatment of, 23 

Nephritis, Acute, 310 

" Chronic, 312 

Interstitial, 312 

" Parenchymatous, 312 

Nephrotosis, 309 

Nerve, the Fifth, 29, 348 

Nervous Exhaustion, , 362 

" Prostration, 362 

Nettle Rash, -. ,,,,.,,.,,.,,,,, ,277 



Index 



Neuralgia, Brachial, 348 

Facial, 348 

Feet, 349 

" Intercostal, 350 

Pedal, 348 

Red, 348 

Spinal, 347 

Stomach, 347 

Neuritis, Brachial, 348 

Neurasthenia, 362 

Neurosis, Occupation, 366 

Normal Curves of Spine, 64 

" " " in Child, 64 

Spine, 64 

Nose, 29 

Nose Bleeding, 389 

Nostrils, 29 

Nutmeg Liver, 290 

O 

Oak, Poison, 400 

Occipital Nerves, . ._ 25 

Occupation Neurosis, '. 366 

Obesity, 253 

Obstruction, _ Intestinal, 283 

Office Examination, 20 

" Description of, 20 

Optic Nerve, Atrophy of, 376 

Osteomalacia, 195 

Osteopathic Lesion, 11 

" Treatment, General, 61 

Stool, 60 

Table, 60 

Technique, 9 

Ovarian Tumors, 377 

Oxyuris Vermicularis, 315 

P 

Palpation, 16 

Palpitation of Heart, 326 

Palsy, Shaking, 367 

Paralysis, 336 

" Agitans, 367 

Cigar Maker's, 366 

Infantile 338 



Practice of Osteopathy 

Paralysis, Milker's, 366 

" Pianist's, 366 

Spastic Spinal, 368 

" Telegrapher's, 366 

Writer's, 366 

Paraplegia, 336 

Spastic, 368 

Parkinson's Disease, 367 

Parotitis, 240 

Passive Congestion of Liver, 293 

Pedal Neuralgia, 349 

Pelvis, Examination of, 50, 52 

" Treatment, 50, 53 

Penman's Paralysis, 366 

Pericarditis, 324 

Percussion, 16 

Perihepatitis, Acute, 292 

" Chronic, 292 

Peristaltic Action, 41 

Peritonitis, 293 

Pernicious Anaemia, 332 

Pertussis, 232 

Petechial Fever, 212 

Petit Mai, .360 

Phthisis, 234 

Pharyngitis, Acute, 267 

" Chronic, 267 

Phlebitis, 316 

Physiology, Knowledge of, 11 

Pianist's Paralysis, 366 

Piles, 278 

Pin Worms, 397 

Pleurodynia, 350 

Pleurisy, Acute, .249 

Chronic, 250 

Dry, 250 

with Effusion, 250 

Pneumogastric Nerve, Located, 25 

" Treated, 25 

Pneumonia, Broncho, 219 

Catarrhal, 219 

Capillary, 219 

" Croupous 216 

" Fibrinous, * 216 

Lobar, 216 

Lobular, .219 

Pneumonitis, ^..^=....,,. .^^..^...,.216 



Index 



Pneumothorax, 216 

Podagra, 264 

Poliomyelitis, 338 

Pott's Disease, 191 

Poison Oak or Ivy, 400 

Preparation for Treatment, 10 

Prostration, Nervous, 362 

Pterygium, 376 

Ptosis, 377 

Pupil, Argyll-Robertson, 370 

Purpuric Fever, Malignant, 212 

Pyopneumomothorax, 251 

Pyriformis Muscle, 296 

Q 

Quinine in Malaria, 204 

Quinsy, 228 

Quotidian Fever, 203 

R 

Rachitis, 251 

Rash, Nettle, 277 

Rectal Treatment of Coccyx, 41 

Rectum, Treatment of, 41 

Red Neuralgia of the Feet, 349 

Renal Dropsy, 313 

Respiration, Artificial, 380, 381 

Respiratory Tract, Diseases of, 251 

Retinitis, 376 

Rheumatic Gout, 262 

Fever, 259 

Rheumatism, Acute Articular, 259 

Inflammatory, 259 

Muscular, 351 

" Sciatic 363 

Rheumatoid Arthritis', 262 

Rickets, 25''1 

Ribs, 43 

" Examination of, 43 

" Treatment of, 43, 47 

" First, 43 

" " Treatment of, 44 

" " Examination of, 44 

" Lesions of, 43, 44 

" Twelfth, Examination of, 47 



Practice of Osteopathy 

Rib, Twelfth, Treatment of, 47, 48 

Rigid Spine, 194 

Romberg's Symptom, 369 

Rotary Curvature of Spine, 189 

Rotheln, 231 

Round Worms, 314 

Rubella, 231 

Rubeola, See Rubella, 231 

S 

Sacral Curve of Spine, 64 

" Region of Spine 64 

Sacrum, Examination of, 41 

" Treatment of, 41 

Scaleni Muscles, 24 

Scarlatina, See Scarlet Fever, 205 

Scarlet Fever, 205 

Sciatica, 363 

Sciatic Rheumatism, 62, 363 

Nerve Stretched, 56 

Scurvy, 269 

Scoliosis, 189 

Shoulder, Dislocation of, 59 

" Treatment of, 59 

Shaking Palsy, 367 

Sick Headache, 371 

Sinus, Frontal 28 

Lateral, 28 

" Longitudinal 28 

Sleeplessness, 346 

Slight Dislocation, 379 

Small Pox, 209 

Smooth Spine, 32 

Solar Plexus, Treatment of 50 

Sore Throat, 267 

Spastic Paraplegia, 368 

" Spinal Paralysis, 368 

Spinal Curvature, 139 

" Neuralgia, 347 

" Inhibition, 40, 271 

/' Paralysis, Infantile, 338 

Spine, The, 64 

" Abnormal, 62 

" Arrangement of Vertebrae, 64 

" Cervical Region, 64 

" Coccygeal Region, 64 



Index 



Spine, Dorsal Region, 64 

" Examination of, 31 

" Inspection of, ' 31 

" Lumbar Region of, 64 

" Normal Curves of, 64 

" Rigid, 34, 194 

" Sacral Region of, 64 

Smooth, 32 

Treatment of, 33 to 41 

Spines, Iliac, 54 

Spiral Treatment of Neck, 27 

Spondylotherapy, 381 

Sporadic Cholera, , 295 

Spotted Fever, 212 

St. Anthony's Fire, 225 

Stenocardia, 328 

Sternum, 43 

Stiff Neck, 351 

Stomach, Catarrh of, 274 

Diseases of, 273 

" ^ Neuralgia of, 347 

Stomatitis, Acute, 266 

Apthous, 267 

Stool, Osteopathic, 60 

Strabismus, 376 

Strangulation of the Bowel, 284 

Stricture, 283 

St. Vitus' Dance, 357 

Subluxations of Limbs, 57 

Sub-Occipital Fossae, 25, 202 

Sudamina, 386 

Sun Stroke, 390 

Supraorbital Nerve, 29 

Superior Cervical Ganglia, 26 

Suppression of Urine, 307 

Sweating of Feet 386 

Sweat Glands, Disordered, 386 

Sylvester's Artificial Respiration, 380 

T 

Tabes Dorsalis, 369 

Table, Osteopathic, 60 

Tachycardia 326 

Taenia, Saginata, 395 

Solieum, 395 

Tape Worms, 395 



Practice of Osteopathy 

Tarsalgia, 349 

Tear Duct, Closed, 376 

" Treated, 29 

Technique, Osteopathic, 9 

Telegrapher's Cramp, 366 

Paralysis, 366 

Tic Douloureux, 348 

Thorax, Examination of, 43 

" Treatment of, 86 

Thread Worms, 397 

Throat, Sore, 267 

Treated, 277 

Thyroid Cartilage, 25 

Toes, Dislocation of, 56 

Tongue, Eczema of, 267 

" Geographical, 267 

Tonsillitis, Acute, 226 

Chronic, 228 

Follicular, 228 

Tonsils Located, 227 

Enlarged, 228 

Torsion of Spine, 39 

Torticollis, 351 

Toxic Anaemia, 329 

Trachoma, 377 

Traction of Spine, 27 

Treatment, Kimono for, 10 

of Abdomen 49 

" Atlas, 27 

" Back, 31 

" " Coccyx, 41 

" Clavicle, 42 

" Eyes, 30 

" General Osteopathic, 61 

of Head, 28 to 32 

" Hyoid Bone, 25 

" " Innominate Bones, 54 

" Ischia, 62 

" Limbs 55 

" Liver, 291, 293 

" Neck 23, 25 

" Pelvis, 50, 53 

" " Pyraformis Muscle, 62 

" Rectum, 41 

" Ribs, 62, 43, 47 

" " Sacrum, 41 

" Special Directions, 19 



Index 



Treatment of Thorax, 43 

" Time Necessary, 18 

of Solar Plexus, 50 

Tuberculosis, 233 

" Chronic Pulmonary, 234 

Diet in, 240 

of Lungs, 234 

Tumors, Abdominal, 374 

Benign, 375 

of Breast, Zld 

Cancerous, 374 

Cystic, 374 

Extra-uterine, 375 

Fatty, 374 

Fibroid, 374 

Interstitial, 375 

Intestinal, 284 

Intra-uterine, 375 

Malignant, 374 

Ovarian, 375 

Uterine, 375 

Typhoid Fever, 198 

Typho-Malaria Fever, 197 

U 

Uremia, 306 

Urinary System, Diseases of, 305 to 314 

Urine, Examination of, 310 

" Incontinence of, 303 

" Suppression of, 307 

Uterine Tumors, 375 

Urticaria, 277 

V 

Valvular Lesions of Heart, 324 

Varicella, 208 

Varicose Veins, 317 

Variola, 209 

Varioloid, 211 

Veins, Enlarged, 317 

" Inflammation of, 316 

Varicose 317 

Vertebra, Atlas Examined 22 

" Axis Examined, 22 

** Atlas Treated, 25 



Practice of Osteopathy 

Vertebra, Axis Treated, 25 

Lumbar, Fifth, 40 

Seventh Cervical, 22 

Vertebrae, Approximation of, 32 

" Deviation of, 31 

Lesions of, 31 

" Separation of, 32 

Vision Impaired, 308 

Voice, Loss of, 25 

Vomiting, 271 

Volvulus, 283 

W 

Warts, 400 

Weak Eyes, 376 

Wet Pack, 206 

Whooping Cough, 232 

Women, Diseases of, 51 

Worms, 395 

Pin, 396 

Tape, 395 

Round, 395 

Thread, 396 

Wrist, Dislocation of, 60 

Writer's Cramps, 366 

Paralysis, 366 

Wry Neck, See Torticollis, 351 



t 

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Chiropractic Books i 

Technic and Practice of I 
Chiropractic 

The New Third Edition, revised and enlarged 

By JOY M. LOBAN, D. C, Ph. C. | 



Used as a text book in many Chiropractic Colleges. 



I 



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Chiropractic Books. — Continued 




Spinal Treatment 



Science and Technique 

By Alva Emery Gregory, M. D., D. C. 



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Chiropractic Books. — Continued 



*^******'^ 



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4^ Chiropractic Books. — Continued 



^ 




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per month in one year. How in three 
months 50 patients were being treated 
in a town of 2,500. 

What is the use of waiting " for some- 
thing to turn up " when you are capable 
of earning from $5,000 to $8,000 per year? 
Your services are needed. 

This is a book of facts not Padded, 
64 pages. 

Price $2.50 

Address all orders to 

MURRAY PUBLISHERS 

465 Douglas Ave., Elgin, 111. 



Sex Force 



This remarkable book presents private 
lessons in the cultivation of Sex Force, 
[t shows this to be the Vital Power of At- 
traction between the Sexes. The work 
teaches its control and Transmutation for 
Greater Strength and higher Develop- 
ment. 

The author of this work has been 
teaching Sex Force to a few privately. 
Finding that these teachings did so much 
good he finally acceded to the urgent re- 
quests of his pupils and consented to 
their being published in book form. The 
author is very well aw^are, however, that, 
ownng to the nature of the teachings 
there will be many misinterpretations of 
their teachings by ignorant persons — for 
this reason he has decided not to reveal 
his name at the present time, as he de- 
sires no personal publicity or notoriety. 
This book is bound in cloth and has 202 
pages. 

Price $1.10. 

Send all orders to the 

MURRAY PUBLISHERS 

465 Douglas Ave., Elgin, 111. 



A A A ^^ A A A A A ^^ A ^ 4 ^4 ^4 A ^4 ^ 4 A A t^^ A- 



Sex Secrets 



By Robert B. Armitage, M. D. 

You should turn on the light by reading this great 
work by this Eminent Authority. The book is in 17 
complete parts of which there are 450 subdivisions. 

The main divisions of the work are: 

Why Sex Secrets Should Be Told. 

The Anatomy and Physiology of Sex. 

The Human Sexual Organism. 

The Psychology of Sex. 

The Evolution of Marriage. 

The Future of Marriage. 

The Fall and Rise of Women. 

The Mistakes of the Bridegroom. 

Immorality in Marriage. 

The Purpose of the Sexual Relation. 

The Dual-Function of the Sex Life. 

Is Continence Harmful? 

The Merits of Continence. 

Standards of Sex Morality. 

The Social Evil. 

Birth Control. 

The price of this book in cloth binding is only $2. 

For sale by 

MURRAY PUBLISHERS 
465 Douglas Ave., Elgin, 111. 






Private 

Sex Lessons 

of a Physician 
FOR 

Married Men and Women 

The greatest amount o£ personal instructions ever 
put in the same number of words. 

Of Special Importance to the Children. 

THE SCIENCE OF BIRTH CONTROL. 

Fewer but better babies should be the aim of every 
married couple. 

THE TIME AND APPEARANCE AND SEX of 
the child under absolute control of the parents. 

By David H. Reeder, Ph. D., M. D., D. O. 

$1.10 prepaid. 

Send for circulars on other sex books. 



For sale by 
MURRAY PUBLISHERS 
465 Douglas Ave., Elgin, 111. 



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